Ophthalmologist gets O.K. to open outpatient surgery center

Lee Birchansky, who gets vote on fifth try, says the certificate of need law is unconstitutional

(File photo) Dr. Lee Birchansky is pictured in one of the operating rooms at Fox Eye Laser & Cosmetic Institute on H Ave
(File photo) Dr. Lee Birchansky is pictured in one of the operating rooms at Fox Eye Laser & Cosmetic Institute on H Avenue NE in Cedar Rapids on Wednesday, Aug. 10, 2016. (Liz Martin/The Gazette)

After applying five times in more than a decade for state permission to open an outpatient eye surgery center in Cedar Rapids, ophthalmologist Lee Birchansky was given the go-ahead this week.

The State Health Facilities Council voted 3-to-2 in Ankeny Wednesday to approve Birchansky’s certificate of need for a surgery center next to his Fox Eye Laser & Cosmetic Institute on H Avenue NE.

Birchansky is one of a growing number of voices in recent years arguing certificate of need laws in 34 states, including Iowa, stifle competition by allowing hospitals and other established health care centers to oppose upstarts. The council’s decision this week was made despite letters of opposition from five Eastern Iowa hospitals or hospital-affiliated surgery centers.

Last month, Birchansky and other plaintiffs teamed up with the Institute for Justice in Virginia to file a federal lawsuit alleging Iowa’s process is unconstitutional.

Birchansky called the council’s decision a “major victory” for “patients, insurers, employers and our community.”

“Unlike multi-specialty surgery centers that must cater to many specialties, as a cataract center our focus is just on eyes,” he said in a prepared statement. “This means my staff will be doing one thing and one thing exceptionally well. It also allows us to have lower costs, provides the most efficient operation and the best outcomes.”

Birchansky did outpatient eye surgeries adjacent to his office at 1136 H Ave NE from 1998 to 2004 in a partnership with UnityPoint Health-St. Luke’s Hospital. When St. Luke’s pulled out, he was left with an empty surgery center. He applied for his own certificate of need and was denied four times.


Birchansky later did cataract surgeries at Fox Eye without having a certificate of need, but the Iowa Department of Public Health ordered him in 2010 to cease or risk a fine.

It’s unclear how soon Birchansky would reopen his outpatient clinic. Documents he submitted with his application say he would seek a new safety inspection and do any retrofitting required as soon as he got the certificate of need.

Birchansky’s application says he will continue to perform cataract surgeries at critical-access hospitals that include the Jones Regional Medical Center in Anamosa and the Marengo Memorial Hospital.

Birchansky said last week he decided to apply again because the Health Facilities Council has turned over since he last tried. Council members include:

Dr. Harold Miller, of Bettendorf; Brenda Perrin, of Cherokee; Roberta Chambers, of Corydon; Connie Schmett, of Clive; and Roger Thomas, of Elkader. Schmett, Miller and Perrin are Republicans, Thomas is a Democrat and Chambers has listed no party affiliation.

Miller, Thomas and Chambers voted for Birchansky’s certificate; Schmett and Perrin opposed it, according to Iowa Department of Public Health Spokeswoman Polly Carver-Kimm.

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