Bill Text: IA HF2388 | 2021-2022 | 89th General Assembly | Introduced
Bill Title: A bill for an act relating to the licensure of ambulatory surgical centers, providing for fees to be considered repayment receipts, and providing penalties.(Formerly HSB 606; See HF 2584.)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2022-04-07 - Committee report approving bill, renumbered as HF 2584. [HF2388 Detail]
Download: Iowa-2021-HF2388-Introduced.html
House
File
2388
-
Introduced
HOUSE
FILE
2388
BY
COMMITTEE
ON
STATE
GOVERNMENT
(SUCCESSOR
TO
HSB
606)
A
BILL
FOR
An
Act
relating
to
the
licensure
of
ambulatory
surgical
1
centers,
providing
for
fees
to
be
considered
repayment
2
receipts,
and
providing
penalties.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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Section
1.
NEW
SECTION
.
135Q.1
Definitions.
1
As
used
in
this
chapter,
unless
the
context
otherwise
2
requires:
3
1.
“Ambulatory
surgical
center”
means
a
distinct
facility
4
that
operates
exclusively
for
the
purpose
of
providing
surgical
5
services
to
patients
not
requiring
hospitalization
and
in
which
6
the
expected
duration
of
services
does
not
exceed
twenty-four
7
hours
following
admission.
“
Ambulatory
surgical
center”
8
includes
a
facility
certified
or
seeking
certification
as
an
9
ambulatory
surgical
center
under
the
federal
Medicare
program
10
or
under
the
medical
assistance
program
established
pursuant
11
to
chapter
249A.
“Ambulatory
surgical
center”
does
not
include
12
the
individual
or
group
practice
office
of
a
private
physician,
13
podiatrist,
or
dentist
who
there
engages
in
the
lawful
practice
14
of
surgery,
or
the
portion
of
a
licensed
hospital
designated
15
for
outpatient
surgical
treatment.
16
2.
“Department”
means
the
department
of
inspections
and
17
appeals.
18
Sec.
2.
NEW
SECTION
.
135Q.2
Purpose.
19
The
purpose
of
this
chapter
is
to
protect
the
public
20
health,
safety,
and
welfare
by
providing
for
the
licensing
and
21
regulation
of
ambulatory
surgical
centers.
22
Sec.
3.
NEW
SECTION
.
135Q.3
Licensure.
23
A
person,
acting
severally
or
jointly
with
any
other
person,
24
shall
not
establish,
operate,
or
maintain
an
ambulatory
25
surgical
center
in
this
state
without
obtaining
a
license
as
26
provided
under
this
chapter.
27
Sec.
4.
NEW
SECTION
.
135Q.4
Application
for
license
——
fee.
28
1.
An
applicant
for
an
ambulatory
surgical
center
license
29
shall
submit
an
application
to
the
department.
Applications
30
shall
be
upon
such
forms
and
shall
include
such
information
31
as
the
department
may
reasonably
require,
which
may
include
32
affirmative
evidence
of
ability
to
comply
with
reasonable
rules
33
and
standards
prescribed
under
this
chapter.
34
2.
An
application
for
an
initial
license
for
an
ambulatory
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surgical
center
shall
be
accompanied
by
a
fee
of
fifty
dollars.
1
3.
The
fees
collected
under
this
section
shall
be
considered
2
repayment
receipts
as
defined
in
section
8.2
and
shall
be
used
3
by
the
department
to
administer
this
chapter.
4
Sec.
5.
NEW
SECTION
.
135Q.5
Issuance
and
renewal
of
5
license.
6
1.
Upon
receipt
of
an
application
for
license
and
the
7
license
fee,
the
department
shall
issue
a
license
if
the
8
applicant
and
the
ambulatory
surgical
center
meet
the
9
requirements
of
this
chapter
and
the
rules
adopted
by
the
10
department.
11
2.
A
license
shall
be
issued
only
for
the
premises
and
12
persons
named
in
the
application.
13
3.
A
license
is
not
transferable
or
assignable
except
with
14
the
written
approval
of
the
department.
15
4.
A
license
shall
be
posted
in
a
conspicuous
place
on
the
16
licensed
premises
as
prescribed
by
rule
of
the
department.
17
5.
Separate
licenses
are
not
required
for
ambulatory
18
surgical
center
facilities
that
are
maintained
on
the
same
19
physical
site
and
that
have
the
same
ownership
or
control.
20
Multiple
buildings
located
on
the
same
physical
site
under
the
21
same
ownership
or
control
shall
be
considered
one
ambulatory
22
surgical
center
facility
for
purposes
of
this
chapter
and
23
section
135.61,
and
may
operate
under
one
license.
24
6.
A
license,
unless
sooner
suspended
or
revoked,
shall
25
expire
on
June
30
of
each
year
and
shall
be
renewed
annually.
26
The
department
shall
renew
a
license
upon
payment
of
a
five
27
hundred
dollar
annual
license
renewal
fee
and
filing
of
an
28
application
for
renewal
at
least
thirty
days
prior
to
the
29
expiration
of
the
existing
license.
The
annual
licensure
fee
30
shall
be
considered
a
repayment
receipt
as
defined
in
section
31
8.2
and
dedicated
to
support
the
staffing
necessary
to
conduct
32
the
inspections
and
investigations
provided
in
section
135Q.8.
33
Sec.
6.
NEW
SECTION
.
135Q.6
Denial,
suspension,
or
34
revocation
of
license
——
hearings
and
review.
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1.
The
department
may
deny,
suspend,
or
revoke
a
license
in
1
any
case
where
it
finds
there
has
been
a
substantial
failure
2
to
comply
with
this
chapter
or
the
rules
and
standards
adopted
3
under
this
chapter.
4
2.
The
denial,
suspension,
or
revocation
of
a
license
by
5
the
department
and
appeal
from
that
action
are
governed
by
the
6
procedures
for
a
contested
case
hearing
under
chapter
17A.
7
3.
a.
If
the
department
finds,
after
providing
notice
of
8
noncompliance
and
a
reasonable
time
for
corrective
action,
that
9
an
ambulatory
surgical
center
is
in
repeated
noncompliance
with
10
this
chapter
or
the
department’s
rules
but
that
noncompliance
11
does
not
endanger
public
health
or
safety,
the
department
may
12
issue
a
conditional
license
to
the
ambulatory
surgical
center
13
as
an
alternative
to
suspending
or
revoking
the
ambulatory
14
surgical
center’s
license.
15
b.
The
department
shall
provide
notice
of
its
intent
to
16
issue
a
conditional
license
to
the
ambulatory
surgical
center
17
and
of
the
items
of
noncompliance
not
less
than
ten
days
before
18
the
date
the
conditional
license
is
issued.
19
c.
The
department
shall
designate
a
period
of
not
more
20
than
one
year
during
which
the
ambulatory
surgical
center
may
21
operate
under
a
conditional
license.
22
d.
During
the
period
an
ambulatory
surgical
center
is
23
operating
under
a
conditional
license,
the
ambulatory
surgical
24
center
shall
correct
the
items
that
are
in
noncompliance
and
25
report
the
corrections
to
the
department
for
approval.
26
4.
The
department
may
suspend
or
revoke
the
license
of
an
27
ambulatory
surgical
center
that
does
not
correct
items
that
28
are
in
noncompliance
or
that
does
not
comply
with
this
chapter
29
or
the
rules
adopted
under
this
chapter
within
the
applicable
30
period.
31
5.
The
department
may
issue
an
emergency
order
to
suspend
32
a
license
issued
under
this
chapter
if
the
department
has
33
reasonable
cause
to
believe
that
the
conduct
of
the
ambulatory
34
surgical
center
creates
an
immediate
danger
to
the
public
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health
and
safety.
An
emergency
suspension
is
effective
1
immediately
without
a
hearing
or
notice
to
the
licensee.
On
2
written
request
of
the
licensee,
the
department
shall
conduct
3
a
hearing
not
earlier
than
the
tenth
day
or
later
than
the
4
thirtieth
day
after
the
date
the
hearing
request
is
received
5
to
determine
if
the
emergency
suspension
is
to
be
continued,
6
modified,
or
rescinded.
The
hearing
and
any
appeal
are
7
governed
by
the
department’s
rules
for
a
contested
case
hearing
8
and
chapter
17A.
9
Sec.
7.
NEW
SECTION
.
135Q.7
Rules.
10
1.
The
department,
with
the
advice
and
approval
of
the
state
11
board
of
health,
shall
adopt
rules
specifying
the
standards
for
12
ambulatory
surgical
centers
to
be
licensed
under
this
chapter.
13
The
rules
shall
be
consistent
with
and
shall
not
exceed
the
14
requirements
of
this
chapter
and
the
conditions
for
coverage
in
15
the
federal
Medicare
program
for
ambulatory
surgical
centers
16
under
42
C.F.R.
pt.
416.
17
2.
The
department
shall
adopt
rules
as
the
department
deems
18
necessary
to
implement
the
provisions
of
this
chapter
relating
19
to
the
issuance,
renewal,
denial,
suspension,
and
revocation
20
of
a
license
to
establish,
operate,
and
maintain
an
ambulatory
21
surgical
center.
22
3.
An
ambulatory
surgical
center
which
is
in
operation
at
23
the
time
of
adoption
of
any
applicable
rules
or
standards
under
24
this
chapter
shall
be
given
a
reasonable
time,
not
to
exceed
25
one
year
from
the
date
of
adoption,
within
which
to
comply
with
26
such
rules
and
standards.
27
4.
The
department
shall
enforce
the
rules.
28
Sec.
8.
NEW
SECTION
.
135Q.8
Inspections.
29
1.
The
department
shall
make
or
cause
to
be
made
inspections
30
or
investigations
of
ambulatory
surgical
centers
to
determine
31
compliance
with
this
chapter
and
applicable
rules
and
32
standards.
The
department
shall
perform
inspections
on
a
33
schedule
that
is
of
the
same
frequency
required
for
inspections
34
of
Medicare-certified
ambulatory
surgical
centers.
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2.
The
department
shall
recognize,
in
lieu
of
its
own
1
licensure
inspection,
the
comparable
inspection
and
inspection
2
findings
of
a
Medicare
conditions
for
coverage
survey
completed
3
by
the
department
or
an
accrediting
organization
authorized
by
4
the
centers
for
Medicare
and
Medicaid
services
with
deeming
5
authority.
6
3.
A
department
inspector
shall
not
participate
in
an
7
inspection
or
investigation
of
an
ambulatory
surgical
center
in
8
which
the
inspector
or
a
member
of
the
inspector’s
immediate
9
family
works
or
has
worked
within
the
last
two
years
or
in
10
which
the
inspector
or
the
inspector’s
immediate
family
has
11
a
financial
ownership
interest.
For
the
purposes
of
this
12
section,
“immediate
family
member”
means
a
spouse,
natural
or
13
adoptive
parent
or
grandparent,
child,
grandchild,
sibling,
14
stepparent,
stepchild,
or
stepsibling.
15
Sec.
9.
NEW
SECTION
.
135Q.9
Employee
background
checks
16
penalty.
17
1.
a.
Prior
to
employment
of
a
person
in
an
ambulatory
18
surgical
center,
the
ambulatory
surgical
center
shall
request
19
that
the
department
of
public
safety
perform
a
criminal
20
history
check
and
the
department
of
human
services
perform
21
child
and
dependent
adult
abuse
record
checks
of
the
person
22
in
this
state.
An
ambulatory
surgical
center
shall
inform
23
all
persons
prior
to
employment
regarding
the
performance
of
24
the
record
checks
and
shall
obtain
from
the
persons
a
signed
25
acknowledgment
of
the
receipt
of
the
information.
26
b.
An
ambulatory
surgical
center
shall
include
the
following
27
inquiry
in
an
application
for
employment:
28
Do
you
have
a
record
of
founded
child
or
dependent
adult
abuse
29
or
have
you
ever
been
convicted
of
a
crime,
in
this
state
or
any
30
other
state?
31
2.
a.
If
it
is
determined
that
a
person
being
considered
32
for
employment
in
an
ambulatory
surgical
center
has
been
33
convicted
of
a
crime,
the
department
of
public
safety
shall
34
notify
the
ambulatory
surgical
center
that
upon
the
request
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of
the
ambulatory
surgical
center
the
department
of
human
1
services
will
perform
an
evaluation
to
determine
whether
the
2
crime
warrants
prohibition
of
the
person’s
employment
in
the
3
ambulatory
surgical
center.
4
b.
If
a
department
of
human
services
child
or
dependent
5
adult
abuse
record
check
shows
that
the
person
has
a
record
of
6
founded
child
or
dependent
adult
abuse,
the
department
of
human
7
services
shall
notify
the
ambulatory
surgical
center
that
upon
8
the
request
of
the
ambulatory
surgical
center
the
department
of
9
human
services
will
perform
an
evaluation
to
determine
whether
10
the
founded
child
or
dependent
adult
abuse
warrants
prohibition
11
of
the
person’s
employment
in
the
ambulatory
surgical
center.
12
c.
An
evaluation
performed
under
this
subsection
shall
13
be
performed
in
accordance
with
procedures
adopted
for
this
14
purpose
by
the
department
of
human
services.
15
d.
(1)
If
a
person
owns
or
operates
more
than
one
16
ambulatory
surgical
center,
and
an
employee
of
one
of
such
17
ambulatory
surgical
centers
is
transferred
to
another
such
18
ambulatory
surgical
center
without
a
lapse
in
employment,
19
the
ambulatory
surgical
center
is
not
required
to
request
20
additional
criminal
and
child
and
dependent
adult
abuse
record
21
checks
of
that
employee.
22
(2)
If
the
ownership
of
an
ambulatory
surgical
center
is
23
transferred,
at
the
time
of
transfer
the
record
checks
required
24
by
this
section
shall
be
performed
for
each
employee
for
whom
25
there
is
no
documentation
that
such
record
checks
have
been
26
performed.
The
ambulatory
surgical
center
may
continue
to
27
employ
such
employee
pending
the
performance
of
the
record
28
checks
and
any
related
evaluation.
29
3.
In
an
evaluation,
the
department
of
human
services
30
shall
consider
the
nature
and
seriousness
of
the
crime
31
or
founded
child
or
dependent
adult
abuse
in
relation
to
32
the
position
sought
or
held,
the
time
elapsed
since
the
33
commission
of
the
crime
or
founded
child
or
dependent
adult
34
abuse,
the
circumstances
under
which
the
crime
or
founded
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child
or
dependent
adult
abuse
was
committed,
the
degree
of
1
rehabilitation,
the
likelihood
that
the
person
will
commit
2
the
crime
or
founded
child
or
dependent
adult
abuse
again,
3
and
the
number
of
crimes
or
founded
child
or
dependent
adult
4
abuses
committed
by
the
person
involved.
If
the
department
of
5
human
services
performs
an
evaluation
for
the
purposes
of
this
6
section,
the
department
of
human
services
has
final
authority
7
in
determining
whether
prohibition
of
the
person’s
employment
8
is
warranted.
9
4.
a.
Except
as
provided
in
paragraph
“b”
and
subsection
2,
10
a
person
who
has
been
convicted
of
a
crime
or
has
a
record
of
11
founded
child
or
dependent
adult
abuse
shall
not
be
employed
12
in
an
ambulatory
surgical
center
licensed
under
this
chapter
13
unless
an
evaluation
has
been
performed
by
the
department
of
14
human
services.
15
b.
A
person
with
a
criminal
or
abuse
record
who
is
or
was
16
employed
by
an
ambulatory
surgical
center
licensed
under
this
17
chapter
and
is
hired
by
an
employer
who
is
another
licensee
18
without
a
lapse
in
employment
shall
be
subject
to
the
criminal
19
history
and
abuse
record
checks
required
pursuant
to
subsection
20
1.
However,
if
an
evaluation
was
previously
performed
by
the
21
department
of
human
services
concerning
the
person’s
criminal
22
or
abuse
record
and
it
was
determined
that
the
record
did
not
23
warrant
prohibition
of
the
person’s
employment
and
the
latest
24
record
checks
do
not
indicate
a
crime
was
committed
or
founded
25
abuse
record
was
entered
subsequent
to
that
evaluation,
the
26
person
may
commence
employment
with
the
other
licensee
in
27
accordance
with
the
department
of
human
services’
evaluation
28
and
an
exemption
from
the
requirements
in
paragraph
“a”
for
29
reevaluation
of
the
latest
record
checks
is
authorized.
30
Otherwise,
the
requirements
of
paragraph
“a”
remain
applicable
31
to
the
person’s
employment.
Authorization
of
an
exemption
32
under
this
lettered
paragraph
“b”
from
requirements
for
33
reevaluation
of
the
latest
record
checks
by
the
department
of
34
human
services
is
subject
to
all
of
the
following
provisions:
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(1)
The
position
with
the
subsequent
employer
is
1
substantially
the
same
or
has
the
same
job
responsibilities
as
2
the
position
for
which
the
previous
evaluation
was
performed.
3
(2)
Any
restrictions
placed
on
the
person’s
employment
in
4
the
previous
evaluation
by
the
department
of
human
services
5
shall
remain
applicable
in
the
person’s
subsequent
employment.
6
(3)
The
person
subject
to
the
record
checks
has
maintained
a
7
copy
of
the
previous
evaluation
and
provides
the
evaluation
to
8
the
subsequent
employer
or
the
previous
licensee
provides
the
9
previous
evaluation
from
the
person’s
personnel
file
pursuant
10
to
the
person’s
authorization.
If
a
physical
copy
of
the
11
previous
evaluation
is
not
provided
to
the
subsequent
employer
12
the
record
checks
shall
be
reevaluated.
13
(4)
Although
an
exemption
under
this
lettered
paragraph
“b”
14
may
be
authorized,
the
subsequent
employer
may
instead
request
15
a
reevaluation
of
the
record
checks
and
may
employ
the
person
16
while
the
reevaluation
is
being
performed.
17
5.
a.
If
a
person
employed
by
an
ambulatory
surgical
center
18
licensed
under
this
chapter
is
convicted
of
a
crime
or
has
a
19
record
of
founded
child
or
dependent
adult
abuse
entered
in
the
20
abuse
registry
after
the
person’s
employment
application
date,
21
the
person
shall
inform
the
ambulatory
surgical
center
of
such
22
information
within
forty-eight
hours
of
the
criminal
conviction
23
or
entry
of
the
record
of
founded
child
or
dependent
adult
24
abuse.
The
ambulatory
surgical
center
shall
act
to
verify
25
the
information
within
forty-eight
hours
of
notification.
If
26
the
information
is
verified,
the
requirements
of
subsections
27
2,
3,
and
4
regarding
employability
and
evaluations
shall
28
be
applied
by
the
ambulatory
surgical
center
to
determine
29
whether
or
not
the
person’s
employment
is
continued.
The
30
ambulatory
surgical
center
may
continue
to
employ
the
person
31
pending
the
performance
of
an
evaluation
by
the
department
32
of
human
services
to
determine
whether
prohibition
of
the
33
person’s
employment
is
warranted.
A
person
who
is
required
by
34
this
subsection
to
inform
the
ambulatory
surgical
center
of
35
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a
conviction
or
entry
of
an
abuse
record
and
fails
to
do
so
1
within
the
required
period
commits
a
serious
misdemeanor.
2
b.
If
an
ambulatory
surgical
center
receives
credible
3
information,
as
determined
by
the
ambulatory
surgical
center,
4
that
a
person
employed
by
the
ambulatory
surgical
center
has
5
been
convicted
of
a
crime
or
a
record
of
founded
child
or
6
dependent
adult
abuse
has
been
entered
in
the
abuse
registry
7
after
employment
from
a
person
other
than
the
employee
and
the
8
employee
has
not
informed
the
ambulatory
surgical
center
of
9
such
information
within
the
period
required
under
paragraph
10
“a”
,
the
ambulatory
surgical
center
shall
act
to
verify
the
11
credible
information
within
forty-eight
hours
of
receipt
of
12
the
credible
information.
If
the
information
is
verified,
the
13
requirements
of
subsections
2,
3,
and
4
regarding
employability
14
and
evaluations
shall
be
applied
by
the
ambulatory
surgical
15
center
to
determine
whether
or
not
the
person’s
employment
is
16
continued.
17
c.
The
ambulatory
surgical
center
may
notify
the
county
18
attorney
for
the
county
where
the
ambulatory
surgical
center
is
19
located
of
any
violation
or
failure
by
an
employee
to
notify
20
the
ambulatory
surgical
center
of
a
criminal
conviction
or
21
entry
of
an
abuse
record
within
the
period
required
under
22
paragraph
“a”
.
23
6.
An
ambulatory
surgical
center
licensed
under
this
24
chapter
may
access
the
single
contact
repository
established
by
25
the
department
pursuant
to
section
135C.33
as
necessary
for
the
26
ambulatory
surgical
center
to
perform
record
checks
of
persons
27
employed
or
being
considered
for
employment
by
the
ambulatory
28
surgical
center.
29
Sec.
10.
NEW
SECTION
.
135Q.10
Confidentiality.
30
The
department’s
final
findings
with
respect
to
compliance
31
by
an
ambulatory
surgical
center
with
requirements
for
32
licensing
shall
be
made
available
to
the
public
in
a
readily
33
available
form
and
place.
Other
information
relating
to
34
an
ambulatory
surgical
center
obtained
by
the
department
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which
does
not
constitute
the
department’s
findings
from
an
1
inspection
of
the
ambulatory
surgical
center
shall
not
be
made
2
available
to
the
public,
except
in
proceedings
involving
the
3
denial,
suspension,
or
revocation
of
a
license
under
this
4
chapter.
The
name
of
a
person
who
files
a
complaint
with
the
5
department
shall
remain
confidential
and
shall
not
be
subject
6
to
discovery,
subpoena,
or
other
means
of
legal
compulsion
for
7
its
release
to
a
person
other
than
department
employees
or
8
agents
involved
in
the
investigation
of
the
complaint.
9
Sec.
11.
NEW
SECTION
.
135Q.11
Injunction.
10
Notwithstanding
the
existence
or
pursuit
of
any
other
11
remedy,
the
department
may,
in
the
manner
provided
by
law,
12
maintain
an
action
in
the
name
of
the
state
for
injunction
13
or
other
process
against
any
person
to
restrain
or
prevent
14
the
establishment,
operation,
or
maintenance
of
an
ambulatory
15
surgical
center
without
a
license.
16
Sec.
12.
NEW
SECTION
.
135Q.12
Judicial
review.
17
Judicial
review
of
an
action
of
the
department
may
be
sought
18
in
accordance
with
chapter
17A.
Notwithstanding
the
provisions
19
of
chapter
17A,
petitions
for
judicial
review
may
be
filed
20
in
the
district
court
of
the
county
in
which
the
ambulatory
21
surgical
center
is
located
or
is
to
be
located
and
the
status
22
quo
of
the
petitioner
or
licensee
shall
be
preserved
pending
23
final
disposition
of
the
judicial
review
matter.
24
Sec.
13.
NEW
SECTION
.
135Q.13
Penalties.
25
Any
person
establishing,
operating,
or
maintaining
any
26
ambulatory
surgical
center
without
a
license
commits
a
serious
27
misdemeanor,
and
each
day
of
continuing
violation
after
28
conviction
shall
be
considered
a
separate
offense.
29
Sec.
14.
Section
135.11,
Code
2022,
is
amended
by
adding
the
30
following
new
subsection:
31
NEW
SUBSECTION
.
29.
Adopt
rules
requiring
ambulatory
32
surgical
centers
to
report
quality
data
to
the
department
of
33
public
health
that
is
consistent
with
the
data
required
to
be
34
reported
to
the
centers
for
Medicare
and
Medicaid
services
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of
the
United
States
department
of
health
and
human
services
1
as
authorized
by
the
Medicare
Improvements
and
Extension
Act
2
of
2006
under
Title
I
of
the
Tax
Relief
and
Health
Care
Act
3
of
2006,
Pub.
L.
No.
109-432,
and
the
regulations
adopted
4
under
such
Acts.
Notwithstanding
any
provision
of
law
to
5
the
contrary,
nothing
in
this
subsection
shall
require
an
6
ambulatory
surgical
center
to
provide
health
data
to
the
7
department
of
public
health
or
any
other
public
or
private
8
entity
that
is
in
addition
to,
different
than,
or
exceeds
9
the
quality
data
required
to
be
reported
to
the
centers
for
10
Medicare
and
Medicaid
services
of
the
United
States
department
11
of
health
and
human
services.
12
Sec.
15.
Section
135.61,
Code
2022,
is
amended
by
adding
the
13
following
new
subsection:
14
NEW
SUBSECTION
.
1A.
“Ambulatory
surgical
center”
means
15
ambulatory
surgical
center
as
defined
in
section
135Q.1.
16
Sec.
16.
Section
135.61,
subsection
14,
paragraph
d,
Code
17
2022,
is
amended
to
read
as
follows:
18
d.
An
outpatient
ambulatory
surgical
facility
center
.
19
Sec.
17.
Section
135.61,
subsection
21,
Code
2022,
is
20
amended
by
striking
the
subsection.
21
EXPLANATION
22
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
23
the
explanation’s
substance
by
the
members
of
the
general
assembly.
24
This
bill
creates
a
new
Code
chapter
to
provide
for
the
25
licensing
and
regulation
of
ambulatory
surgical
centers.
The
26
department
of
inspections
and
appeals
(DIA)
is
designated
to
27
enforce
the
regulations.
28
The
bill
provides
that
the
purpose
of
the
new
Code
chapter
is
29
to
protect
the
public
health,
safety,
and
welfare
by
providing
30
for
the
licensing
and
regulation
of
ambulatory
surgical
31
centers.
The
bill
prohibits
the
establishment,
operation,
32
or
maintenance
of
an
ambulatory
surgical
center
in
the
state
33
without
obtaining
a
license.
34
The
bill
provides
the
process
for
application
for
licensure.
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An
application
for
an
initial
license
is
required
to
be
1
accompanied
by
a
fee
of
$50.
The
fees
collected
are
repayment
2
receipts
and
are
to
be
used
by
DIA
to
administer
the
new
Code
3
chapter.
4
The
bill
provides
for
the
issuance
and
renewal
of
licenses.
5
A
license
is
to
be
issued
only
for
the
premises
and
persons
6
named
in
the
application;
is
not
transferable
or
assignable
7
except
with
the
written
approval
of
DIA;
and
is
required
to
8
be
posted
in
a
conspicuous
place
on
the
licensed
premises
as
9
prescribed
by
rule
of
DIA.
The
bill
provides
that
separate
10
licenses
are
not
required
for
ambulatory
surgical
center
11
facilities
that
are
maintained
on
the
same
physical
site
and
12
that
have
the
same
ownership
or
control.
Multiple
buildings
13
located
on
the
same
physical
site
under
the
same
ownership
or
14
control
are
considered
one
ambulatory
surgical
center
facility
15
for
purposes
of
the
new
Code
chapter
and
Code
chapter
135,
16
division
VI,
relating
to
the
health
facilities
council
and
17
certificate
of
need
provisions,
and
are
to
be
permitted
to
18
operate
under
one
license.
Licenses
expire
on
June
30
of
each
19
year
and
are
required
to
be
renewed
annually.
The
bill
directs
20
DIA
to
renew
a
license
upon
payment
of
a
$500
annual
license
21
renewal
fee
and
the
filing
of
an
application
for
renewal
at
22
least
30
days
prior
to
the
expiration
of
the
existing
license.
23
The
annual
licensure
fee
is
considered
a
repayment
receipt
and
24
is
to
be
dedicated
to
support
the
staffing
necessary
to
conduct
25
the
inspections
and
investigations
under
the
new
Code
chapter.
26
The
bill
provides
for
denial,
suspension,
or
revocation
of
27
licenses.
A
license
may
be
denied,
suspended,
or
revoked
if
28
DIA
finds
there
has
been
a
substantial
failure
to
comply
with
29
the
new
Code
chapter
or
the
rules
and
standards
adopted
under
30
the
new
Code
chapter.
The
denial,
suspension,
or
revocation
31
of
a
license
by
DIA
and
appeal
from
that
action
are
governed
by
32
the
procedures
for
a
contested
case
hearing
under
Code
chapter
33
17A.
The
bill
authorizes
DIA,
after
providing
notice
of
34
noncompliance
and
a
reasonable
time
for
corrective
action,
and
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if
the
noncompliance
does
not
endanger
public
health
or
safety,
1
to
issue
a
conditional
license
to
the
ambulatory
surgical
2
center
as
an
alternative
to
suspending
or
revoking
its
license.
3
The
bill
also
authorizes
DIA
to
issue
an
emergency
order
4
to
suspend
a
license
if
DIA
has
reasonable
cause
to
believe
5
that
the
conduct
of
the
ambulatory
surgical
center
creates
an
6
immediate
danger
to
the
public
health
or
safety.
On
written
7
request
of
the
licensee,
DIA
is
required
to
conduct
a
hearing
8
to
determine
if
the
emergency
suspension
is
to
be
continued,
9
modified,
or
rescinded.
The
hearing
and
any
appeal
are
10
governed
by
DIA’s
rules
for
a
contested
case
hearing
and
Code
11
chapter
17A.
12
The
bill
directs
DIA
to
adopt
rules
with
the
advice
and
13
approval
of
the
state
board
of
health
to
specify
the
standards
14
for
ambulatory
surgical
centers.
The
rules
are
required
to
be
15
consistent
with
and
not
exceed
the
requirements
of
the
new
Code
16
chapter
and
the
conditions
for
coverage
in
the
federal
Medicare
17
program
for
ambulatory
surgical
centers.
DIA
is
also
directed
18
to
adopt
rules
relating
to
provisions
of
the
new
Code
chapter
19
relating
to
the
issuance,
renewal,
denial,
suspension,
and
20
revocation
of
a
license
to
establish,
operate,
and
maintain
an
21
ambulatory
surgical
center.
If
an
ambulatory
surgical
center
22
is
in
operation
at
the
time
of
adoption
of
any
applicable
rules
23
or
standards,
the
center
is
to
be
given
a
reasonable
time,
not
24
to
exceed
one
year
from
the
date
of
adoption,
within
which
to
25
comply
with
such
rules
and
standards.
26
The
bill
provides
for
inspections
or
investigations
of
27
ambulatory
surgical
centers,
and
directs
that
DIA
shall
28
perform
inspections
on
a
schedule
that
is
of
the
same
frequency
29
required
for
inspections
of
Medicare-certified
ambulatory
30
surgical
centers.
The
bill
also
requires
DIA
to
recognize,
in
31
lieu
of
its
own
licensure
inspection,
the
comparable
inspection
32
and
inspection
findings
of
a
Medicare
conditions
for
coverage
33
survey.
34
The
bill
prohibits
a
DIA
inspector
from
participating
in
an
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inspection
or
investigation
of
an
ambulatory
surgical
center
in
1
which
the
inspector
or
a
member
of
the
inspector’s
immediate
2
family
works
or
has
worked
within
the
last
two
years
or
in
3
which
the
inspector
or
the
inspector’s
immediate
family
has
a
4
financial
ownership
interest.
5
The
bill
requires
an
ambulatory
surgical
center
to
comply
6
with
child
and
dependent
adult
abuse
information
and
criminal
7
record
checks
and
evaluations.
8
The
bill
provides
confidentiality
provisions
relating
to
9
ambulatory
surgical
center
information.
The
final
findings
10
with
respect
to
compliance
by
an
ambulatory
surgical
center
11
are
to
be
made
available
to
the
public
in
a
readily
available
12
form
and
place.
Other
information
relating
to
an
ambulatory
13
surgical
center
shall
not
be
made
available
to
the
public,
14
except
in
proceedings
involving
the
denial,
suspension,
or
15
revocation
of
a
license.
The
name
of
a
person
who
files
a
16
complaint
with
DIA
is
required
to
remain
confidential
and
not
17
be
subject
to
discovery,
subpoena,
or
other
means
of
legal
18
compulsion.
19
The
bill
provides
for
injunctive
relief
and
judicial
review.
20
The
bill
provides
that
any
person
establishing,
operating,
21
or
maintaining
an
ambulatory
surgical
center
without
a
license
22
commits
a
serious
misdemeanor,
and
each
day
of
continuing
23
violation
after
conviction
shall
be
considered
a
separate
24
offense.
A
serious
misdemeanor
is
punishable
by
confinement
25
for
no
more
than
one
year
and
a
fine
of
at
least
$430
but
not
26
more
than
$2,560.
27
The
bill
also
directs
the
department
of
public
health
(DPH)
28
to
adopt
rules
requiring
ambulatory
surgical
centers
to
report
29
quality
data
to
DPH
that
is
consistent
with
the
data
required
30
to
be
reported
to
the
centers
for
Medicare
and
Medicaid
31
services
of
the
United
States
department
of
health
and
human
32
services.
However,
the
rules
shall
not
require
an
ambulatory
33
surgical
center
to
provide
health
data
to
DPH
or
any
other
34
public
or
private
entity
that
is
in
addition
to,
different
35
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than,
or
exceeds
the
quality
data
required
to
be
reported
to
1
the
centers
for
Medicare
and
Medicaid
services
of
the
United
2
States
department
of
health
and
human
services.
3
The
bill
makes
conforming
changes
in
the
Code
to
reflect
the
4
terminology
of
“ambulatory
surgical
center”.
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