SB 1005 Modifies and enacts new provisions pertaining to health care facilities
Sponsor: Stouffer
LR Number: 4849S.03I Fiscal Note: 4849-03
Committee: Aging, Families, Mental & Public Health
Last Action: 4/12/2006 - SCS Voted Do Pass S Aging, Families, Mental & Public Health Committee (4849S.07C) Journal Page:
Title: Calendar Position:
Effective Date: August 28, 2006

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Current Bill Summary


SCS/SB 1005 - 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, but not be limited to, 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.

AMBULATORY SURGICAL CENTER LICENSURE

Currently, licensure requirements for an ambulatory surgical center require that a physician from the center must have surgical privileges with a licensed hospital in the community in which the center is located, or the center must have a current working agreement on transfer of patients with such a hospital.

Under this act, the provision on transfer agreements is repealed, however, ambulatory surgical centers operating under such agreement before August 28, 2006, could continue to do so.

This act requires hospitals to create an affiliated medical staff membership for physicians who invest in or perform surgery at an ambulatory surgical center in the community and who do not already have hospital medical staff privileges. Hospitals shall not use investment in or performing surgery at an ambulatory surgical center as a basis for denying affiliated medical staff membership if:

- the physician is otherwise qualified for medical staff membership under credentialing procedures and laws; and

- the physician makes himself or herself available to provide on-call services on the same basis as other credentialed practitioners in similar specialties who are required to be on call at the hospital.

The requirement to serve on the hospital's on-call roster may be fulfilled without the practitioner being personally available if he or she makes written agreements for another credentialed practitioner of the same specialty to meet the call coverage requirements of the hospital in his or her stead.

In the case of a dispute over affiliated medical staff privileges, the physician may ask the department of Health and Senior Services to provide mediation.

An ambulatory surgical center shall be considered to be in the same community as a hospital if:

-in a metropolitan statistical area the two are in the same service area based on a community-based emergency services plan; or

-outside a metropolitan statistical area, the two are in the same county, or under certain circumstances, in adjacent counties.

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.

CERTIFICATE OF NEED

This act removes certificate of need review of medical equipment in hospitals and ambulatory surgical centers. Certificate of need remains for new hospitals and all aspects of long-term care including long-term care facilities, long-term care beds in hospitals and long-term acute care hospitals. A "new hospital" is defined as a facility which would be newly licensed as a hospital as the result of construction or of renovation or conversion of any structure not licensed as a hospital. Current certificate of need requirements apply to a wider range of health care facilities.

This act provides that in determining whether a certificate of need should be granted to a long-term care facility, no consideration shall be given to the facilities or equipment of any other long-term care facility located more than a fifteen-mile radius of the applying facility. Also, in determining whether a certificate of need should be granted to a long-term acute care hospital, no consideration shall be given to the facilities or equipment of any other long-term acute care hospital located more than a fifty-mile radius of the applying facility.

This act also provides that the CON review process shall not take into account or discriminate against a proposed project based on the investor or investors of the proposed project.

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.

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.

ADRIANE CROUSE