AAASC State Advocacy Program Hosts Conference Call for State Association Leaders

JOHNSON CITY, Tenn. -- The American Association of Ambulatory Surgery Centers (AAASC)’s State Advocacy Program hosted a State Association Leadership conference call on Nov. 1, 2005, for all state association leaders. This regular, quarterly update and networking conference call included an update from state leaders on 2006 legislative/regulatory priorities; reviewed the need for focused conference calls for state association lobbyists on high-priority topics (e.g., out of network and data collection) and provided an update on ASC legislation in Congress and the grassroots advocacy support from state associations.

The states participating in the conference call included: Arkansas, California, Florida, Georgia, Idaho, Illinois, Indiana, Kentucky, Maine, Ohio, Tennessee, Virginia, and Wisconsin. Missouri, Texas, and Michigan were unable to attend but provided updated information.

More than 25 participants included state association presidents, executive directors, and lobbyists. Each state provided an update on their activities, with a particular focus on what legislative and regulatory issues were expected in 2006. A summary is listed below:

Certificate of Need

-- The Georgia Association reported that work on the CON Commission continues; no legislative recommendations are expected until late 2006 for consideration in 2007 legislative session. The Georgia Association has a seat on the CON Commission.

-- The Maine Association reported that CON reform is a high priority issue for the 2006 legislative session. The impact on ASCs is uncertain, but most initiatives are more restrictive for ASCs.

-- Michigan bill HB5055 was approved by Gov. Jennifer Granholm on Oct. 27 and became Public Act 187, effective immediately. HB 5055 amends the Public Health Code to update provisions related to the quality assurance assessment program (QAAP) for nursing homes and hospitals that have been implemented to reduce state general fund costs and finance Medicaid payment rate increases to affected providers. The bill amends the same section of law that establishes the license and certificates of need fee schedule for freestanding surgical out patient facilities. However, those provisions were not amended.

Out of Network

-- The Idaho Association reported that managed care contracting issues continue to be a high priority in the state. No issues for 2006 legislative session were identified to date, though CON and licensure may be debated.

Data Collection

-- The Indiana Association reported that the state recently started a web based consumer information site that includes information on ASCs. Efforts to require ASCs to report adverse events are also underway.

-- The Kentucky Association reported that discussions with the state continue on implementing new data reporting requirements.

-- The Wisconsin Association reported that legislation is expected for 2006 to require reporting of infection rates.

-- A new online resource in Massachusetts will eventually give patients access to information regarding the cost and quality of medical procedures in ASCs. The site currently offers data and statistics for hospitals, nursing homes, and physician groups, but will eventually include ASCs.

“Making this information accessible is an innovative step, and we urge consumers to use the data, talk with their healthcare providers, and seek out additional resources to help them make the right decisions for themselves and their families,” said Massachusetts Gov. Mitt Romney.

Workers Compensation

-- The Illinois Association reports that the state has begun to work on workers compensation reform with proposed changes in ASC payment expected.

Physician Ownership

-- The California Association plans to introduce legislation in 2006 to revise and update the requirements for physicians to disclose any financial interest they may have in an ASC for workers compensation.

Licensure

-- Measures to streamline licensure for all healthcare providers, including ASCs, is expected to occur in Florida in 2006.

-- The Ohio Association reported that work is underway to cooperate with the state in updating ASC licensure regulations. Changes are expected, but more “fine-tuning” is expected rather than a major overhaul.

-- The California Association plans to introduce legislation in 2006 to revise state requirements for ASC licensure to update the provisions and help improve the timeliness of licensure surveys.

-- The Texas Association reported that effective Nov. 1, 2005, the state Department of Health Services will adopt amendments to rules for Texas ASCs that will clarify definitions and add new requirements to providing anesthesia, staffing issues, as well as reporting of adverse incidents.

Miscellaneous

-- The Missouri Department of Social Services, Division of Medical Services (DMS), released an Ambulatory Surgical Center (ASC) Bulletin on Oct. 27. The bulletin highlights what DMS added and deleted from the list of Medicaid-covered ASC codes to reflect updates to the list of procedures determined by the Centers for Medicare and Medicaid Services (CMS) to be appropriate for the ASC setting.

-- The Missouri Association reported that one of its members is in a legal struggle regarding hospital privileges which may determine the survival of the newly opened center.

-- On Oct. 17, Wisconsin SB 388 was introduced and referred to the Senate Committee on Health, Children, Families, Aging and Long Term Care. This bill would establish a publicly financed healthcare system for state residents. The health plan would allow each eligible person, regardless of any preexisting condition, to receive reasonable medical service necessary to maintain health, enable diagnosis, or provide treatment or rehabilitation for an injury, condition, disability, or disease, for which reimbursement shall be made. Coverage would include orthodontia or medically-necessary reconstructive or cosmetic surgery.

Source: AAASC