SB 1245 - This act relates to health care facilities.
HEALTH CARE CONSUMER WEBSITE - This act provides that by January 1, 2007, the Department of Health and Senior Services shall implement a long-range plan for making available cost and quality outcome data on its Internet website that will allow consumers to compare health care services. The data shall include information on licensed physicians, hospitals and ambulatory surgical centers. The data shall be made available on the department's website no later than January 1, 2010.
PHYSICIAN SELF-REFERRAL - This act provides that no physician shall refer a patient to any health care facility in which the physician has an ownership interest or with which the physician has an employment or contractual relationship unless:
(1) The referring physician will continue to provide treatment to the patient at the hospital to which the patient is referred; or
(2) The physician provides written disclosure to the patient of the physician's ownership interest, employment relationship or contractual relationship with the hospital to which the patient is referred. Violations of this provision shall constitute grounds for licensure denial, suspension or revocation.
An ownership interest includes a direct or indirect interest held by the physician or the physician's spouse or dependent children through equity, debt or other means. To refer a patient under this provision means any act by a physician of providing a request or order for one or more inpatient or nonemergency outpatient hospital services for or establishment of a plan of care that includes one or more inpatient or nonemergency outpatient hospital services for the patient.
AMBULATORY SURGICAL CENTER PROVIDER TAX - This act provides that each licensed ambulatory surgical center in this state must pay, in addition to all other fees or taxes required by law, an ambulatory surgical center reimbursement based on a formula set forth in rules promulgated by the Department of Social Services. No reimbursement allowance will be collected in the event the federal Centers for Medicare and Medicaid Services determines that such reimbursement allowance is not authorized under title XIX of the Social Security Act.
The act provides record retention and reporting requirements for ambulatory surgical centers. The director of the Department of Social Services will make a determination as to the amount of reimbursement allowance due from each ambulatory surgical center and notify each center of the amount due. Reimbursement allowance amounts due may be offset if requested by the center.
Reimbursement allowances will be paid to the Department of Social Services to be deposited into the Ambulatory Surgical Center Federal Reimbursement Allowance Fund created in this act.
The act contains provisions relating to unpaid and delinquent payments and the Department of Social Services ability to compel payment. The director of the Department of Social Services may deny, suspend or revoke an ambulatory surgical center which fails to pay a center's delinquent reimbursement allowance unless under appeal.
STAFF PRIVILEGES - This act provides that no hospital shall refuse or fail to grant or renew staff privileges or condition staff privileges, based in whole or in part on the fact that the physician or a partner, associate, or employee of the physician is providing medical or health care services at a different hospital system or any other health care facility.
COVENANT NOT TO COMPETE - This act provides for the utilization of non-compete clauses in certain situations. The act defines a "physician employment covenant not to compete" as an agreement or part of a contract of employment in which the physician agrees for a specific period of time, not to exceed five years, and within a particular area to refrain from competition with the employer. This act makes covenants not to compete enforceable with other health care facilities as long as they:
(1) Are ancillary to or part of an otherwise enforceable agreement between physician and employer;
(2) Do not deny the physician access to a list of patients the physician treated prior to the physician's buying out or otherwise lawfully terminating the physician employment covenant not to compete;
(3) Provide access to patient medical records with the patient's consent and in an accessible format;
(4) Provide for a buy-out of the covenant by the physician compensating the employer for the remaining amortized cost of recruitment, investments, remuneration and other expenses incurred pursuant to the contract; and
(5) Provide that the physician will not be prohibited from providing continuing treatment to specific acutely ill patients after the contract has terminated.
CERTIFICATE OF NEED - This act limits application of certificate of need requirements to long-term care facilities and long-term acute care hospitals. Current certificate of need requirements apply to a wider range of health care facilities.
DISCLOSURE BEFORE REFERRAL - This act requires a physician to provide certain information to an individual before referring the individual to a health care facility in which the physician has an ownership interest or to a hospital where the physician is employed. This act also provides certain exceptions to the disclosure requirement.
This act is similar to SB 1005 (2006)