Introduced

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.

SPECIALTY HOSPITALS - This act provides that a specialty hospital shall not accept a patient referral from a physician who has an ownership interest in the specialty hospital. 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. A patient referral includes a request or order by a physician for one or more inpatient or nonemergency outpatient hospital services for the patient.

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Under this act, the provision on transfer agreements is repealed, however, ambulatory surgical centers operating under such agreement before August 28, 2006, could continue to do so.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

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 same emergency services catchment area defined by the department to monitor ambulance diversion; or

-outside a metropolitan statistical area, the two are in the same county, or under certain circumstances, in adjacent counties. However, in all cases, the ambulatory surgical center and the hospital must be within thirty miles driving distance.

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.

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. 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.

ADRIANE CROUSE