January 16, 2012 | Comments Off on State to License One Room ORs
Posted by Sharlene Hunt
Last week the legislature adopted S-2780, which amends the law governing surgical practices and will require them to be licensed by the Department of Health & Senior Services. A surgical practice consists of one operating room with one or more post-anesthesia care units or a dedicated recovery area, established by a physician or a physician professional practice solely for the physician’s or practice’s private medical practice. These single ORs within a physician’s practice have historically been exempt from the licensing laws, which require licensure of an ambulatory surgical center. In 2009 changes to the law were adopted that required the single ORs to register with the Department of Health and Senior Services and to obtain certification from the Centers for Medicare and Medicaid Services (CMS) as an ambulatory surgery center provider, or to obtain accreditation as an ambulatory care facility from an accrediting body recognized by CMS. Under the new bill, surgical practices have one year within which to become licensed.
One aspect of the licensing regulations that is difficult for these types of facilities to meet is the physical plant requirement. Some exceptions to this requirement are built into the new law for Medicare certified facilities or facilities that are accredited. A surgical practice is exempt from the physical plant and functional requirements under the ambulatory care facility licensing regulations if it (1) is certified by CMS as an ambulatory surgery center provider, (2) is not Medicare certified, but has obtained accreditation from an accrediting body recognized by CMS and is in operation on the effective date of the bill, or (3) is not in operation on the effective date of the bill but becomes certified by CMS as an ambulatory surgery center provider. If a surgical practice is required to meet the physical plant and functional requirements, it may apply for a waiver of one or more of these requirements as permitted under the existing licensing regulations.
A surgical practice required to be licensed under the law is exempt from the ambulatory care facility assessment unless it expands to include additional ORs. The moratorium imposed on new surgical practices and ambulatory surgery centers in 2009 remains in place. In addition, upon the effective date of the new bill, the Department of Health is prohibiting from issuing any new registrations to surgical practices under the prior law. Instead, a new surgical practice (meeting one of the exceptions to the moratorium, for example by having filed its plans before the statutory cut-off date), would proceed directly with licensure rather than registration.
The bill further requires all ambulatory surgery centers and surgical practices to report to the Department of Health any change of ownership within 30 days of the change of ownership, to file annual reports listing the facility’s medical director, physician director, physician director of anesthesia, and director of nursing services, and to notify the Department of any change within 30 days of the change in any of these director positions.
The bill purportedly had wide support, and was adopted by a large majority in both houses, thus we would expect the governor to sign the bill. Also passed by the legislature last week was a bill that would phase out the cosmetic surgery tax.