AAASC Updates State ASC Chapter Lobbyists on Legislative Efforts

JOHNSON CITY, Tenn. -- The American Association of Ambulatory Surgery Centers (AAASC) State Advocacy Program hosted a conference call for state ASC association lobbyists on Dec. 1, 2005. The conference calls will become a monthly opportunity to network and receive updates on best practices in the ASC industry. The call included an update on 2006 state legislative priorities; an identification of concerns or “gaps” in state association efforts; a review of the need for focused conference calls for lobbyists and for high priority topics such as out of network and data reporting. An update on the grassroots advocacy resources from AAASC was also provided. States that participated in the conference call were: California, Maine, Massachusetts, Missouri, Ohio, New Hampshire, South Carolina, Tennessee, Colorado, and Florida.

Lawmakers have begun to pre-file legislation on a myriad of issues in preparation for the 2006 legislative season during which 44 states are scheduled to meet. Pre-filed bills are highlighted below.

The 2006 season will begin Jan. 2, 2006 when the opening gavel falls in Ohio. All but six states begin their deliberations in January, and North Carolina is the final state scheduled to convene with a session set to start May 9, 2006. Most states are entering the second year of a two-year term which means serious work should begin quickly, as there is less pomp and ceremony scheduled this year than last. California lawmakers will begin working on carryover bills when they convene on Jan. 4, 2006 as holdover legislation is exempt from rules that stipulate new bills must be deferred for a month before hearings may be held. Four states are currently in regular session: Michigan, New Jersey, Ohio and Wisconsin. Pennsylvania is currently holding a special session.

ASC Licensure

-- Louisiana legislators are considering a pair of special session bills relating to healthcare provider licensing, provider agreements and the facility need review process in areas affected by declarations of emergency or disaster. HB 165S and SB 107S would protect licensed healthcare facilities, including ASCs, whose provision of services is interrupted as a result of an emergency event or disaster from having their license or provider agreement terminated or revoked by the department of health and hospitals.

-- HB 165S was introduced and referred to the House Committee on Health and Welfare on Nov. 15, 2005. SB 107S was also introduced on Nov. 15, but has since been amended by the Senate Committee on Health and Welfare, amended on the Senate floor, and passed unanimously on Nov. 17, 2005. Both bills are now pending consideration by the House Committee on Health and Welfare.

-- A Wisconsin bill relating to administering anesthesia in an office-based setting was introduced and referred to the Committee on Health, Children, Families, Aging and Long-Term Care on Nov. 15, 2005. SB 434 applies to “office-based settings,” defined as settings where medical services are performed but that are not a dentist’s office, hospital or an ASC. The bill would prohibit a person from administering anesthesia in an office-based setting unless they are either a physician who meets the medical examining board’s standards of education and training for administering anesthesia, or they are under the direct supervision of a properly trained and educated physician. It would also require the board and each office that performs anesthesia to establish written guidelines for the proper care and treatment of patients who receive anesthesia. Finally, it would require the presence of a physician trained in resuscitative techniques and appropriate resuscitative equipment whenever a person receives anesthesia in an office-based setting, and require each office to report to the board any complications related to surgery or to anesthesia that arise.

-- Florida HB 427, regulating surgical first assistants’ licensure and practice, was pre-filed on Nov. 22, 2006. This bill would establish the duties, scope and location of practice for certified surgical first assistants, including requirements for supervising physicians, contracting and employment guidelines for physicians, hospitals, clinics, or ASCs, and licensure, application and continuing education requirements for certified surgical first assistants. The bill only allows a certified surgical first assistant to perform his or her duties in a medical clinic, hospital, ASC, or similar medical institution and prohibits an HMO, PPO, or health benefit plan from requiring a physician, hospital, clinic, or ASC to contract with the assistant as a condition of payment to a certified surgical first assistant. If enacted, the provisions of the bill would become effective July 1, 2006.

Data Reporting

-- The New Jersey Health Claims Authorization Processing and Payment Act was introduced and referred to the Senate Commerce Committee on Nov. 10, 2005. SB 2824 is identical to AB 3486 and contains similar provisions to SB 2816, a bill amending the “prompt pay act” that was introduced last week. All three bills contain provisions regarding “utilization management systems,” which include preauthorization of ambulatory care procedures and retrospective review. SB 2816 would require a payer to respond to a request for authorization of services by either approving or denying the request based on a utilization management decision.

-- The Chicago Sun-Times recently examined the new Illinois Hospital Assessment Program as enacted by SB 157/Public Act 94-0242 from the 2005 session. The program, due to take effect Jan. 1, 2008, will require hospitals and ASCs in the state to publicly admit if they commit any of 24 types of errors known as “never events” within 30 days after the discovery of the incident. Never events include performing the wrong surgical procedure, leaving a foreign object left in a patient after surgery, using the wrong blood type, or causing a patient death with a medication overdose. Healthcare centers, including ASCs, will be required to analyze the cause and take corrective action after each event. No information concerning healthcare professionals, employees, or patients is required for the report and the state will not take disciplinary action for the mistakes. The purpose of the bill is to create a reporting system to help improve healthcare quality, as opposed to investigating or punishing healthcare facilities.

Physician Investment and Referral

-- The New Hampshire Criminal Justice and Public Safety Subcommittee has voted unanimously to release HB 489 when the legislative session reconvenes on Jan. 4, 2006. This bill would revise the penalties for a healthcare practitioner’s failure to report an ownership interest in certain healthcare facilities and businesses. It would amend RSA 125:25-c, VIII by placing a 30-day time limit for a practitioner to disclose their ownership interest in a facility or business and by making their license and registration revocation for failing to do so automatic. The bill would increase the fines for failing to report one’s interest or referrals and would add that “any resident of New Hampshire” may refer complaints of violations to the appropriate board or agency.

ASC Miscellaneous

-- A New Jersey bill that would prohibit certain ASCs from denying appropriate services to a patient on the basis of their ability to pay or on the source of payment has been introduced. AB 4598 would apply to any licensed ambulatory care facility that meets all of the following criteria:

-- It is not affiliated with a general hospital

-- It commences operations on or after Jan. 1, 2006

-- It primarily provides cancer-related diagnostic and treatment services, including but not limited to, radiation, chemotherapy, diagnostic radiology and medical and surgical consultation

-- It has a total square footage in excess of 100,000 square feet.

Violators would be liable to a civil penalty of $10,000 per violation. This bill was introduced on Nov. 10, 2005 and was referred to the Assembly Financial Institutions and Insurance Committee. If enacted, it would go into effect Jan. 1, 2006, but the Commissioner of Health and Senior Services could take anticipatory administrative action in advance as necessary for its implementation.

-- Officials from Indiana's Terre Haute Regional Hospital have announced that they are seeking a one-year moratorium on the construction of surgery centers by any medical business not currently operating in Vigo County. The moratorium would establish a committee to review the need of such a center and report that recommendation back to the Vigo County Board of Commissioners. Initially, hospital officials were seeking a two-year ordinance from commissioners, then reduced that request to 12 months for an ordinance after the commissioners expressed concerns that it could open them up to legal challenges. At least three other counties in the state that have adopted such restrictions have been taken to court, including a federal lawsuit filed in April against Morgan County contesting the county’s temporary moratorium on construction of new medical facilities.

-- The Missouri Association had reported that one of its members was in a legal struggle regarding hospital privileges, and the confrontation may have determined the survival of the newly opened center. As of Dec. 2, 2005, the Missouri Department of Health and Senior Services granted full licensure to the surgery center after extensive lobbying.

-- The AAASC State Resource Library provides information related to state legislative or regulatory issues of importance to the ASC industry. South Carolina recently provided a copy to the Resource Library of their state health plan that governs ASCs and the building of new centers.

The ASC Advocacy Center is designed to educate and empower the ASC community to take action on important issues affecting the industry. The ASC Advocacy Center allows ASC leaders to develop relationships not only on the federal level but also within their respective states. AAASC is embarking on a major advocacy campaign to assist state ASC associations in educating their state legislators on the role and benefits of ASCs. More information on this initiative can be found at www.aaasc.org

Source: AAASC