House
Study
Bill
521
-
Introduced
HOUSE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
STATE
GOVERNMENT
BILL
BY
CHAIRPERSON
COWNIE)
A
BILL
FOR
An
Act
relating
to
the
licensure
of
ambulatory
surgical
1
centers,
providing
fees
and
penalties,
and
including
2
effective
date
provisions.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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_____
Section
1.
Section
135C.33,
subsection
5,
paragraph
a,
Code
1
2011,
is
amended
by
adding
the
following
new
subparagraph:
2
NEW
SUBPARAGRAPH
.
(6)
An
employee
of
an
ambulatory
surgical
3
center
licensed
under
chapter
135P.
4
Sec.
2.
NEW
SECTION
.
135P.1
Definitions.
5
1.
“Ambulatory
surgical
center”
means
any
distinct
facility
6
that
operates
exclusively
for
the
purpose
of
providing
surgical
7
services
to
patients
not
requiring
hospitalization
and
in
which
8
the
expected
duration
of
services
would
not
exceed
twenty-four
9
hours
following
an
admission.
10
2.
“Department”
means
the
department
of
inspections
and
11
appeals.
12
3.
“Governmental
unit”
means
the
state,
or
any
county,
13
municipality,
or
other
political
subdivision,
or
any
14
department,
division,
board,
or
other
agency
of
any
of
the
15
foregoing.
16
Sec.
3.
NEW
SECTION
.
135P.2
Purpose.
17
The
purpose
of
this
chapter
is
to
protect
the
public
18
health,
safety,
and
welfare
by
providing
for
the
development,
19
establishment,
and
enforcement
of
basic
standards
for
the
20
operation,
construction,
and
maintenance
of
ambulatory
surgical
21
centers.
22
Sec.
4.
NEW
SECTION
.
135P.3
Licensure.
23
No
person
or
governmental
unit,
acting
severally
or
jointly
24
with
any
other
person
or
governmental
unit,
shall
establish,
25
operate,
or
maintain
an
ambulatory
surgical
center
in
this
26
state
without
obtaining
a
license
as
provided
under
this
27
chapter.
28
Sec.
5.
NEW
SECTION
.
135P.4
Application
for
license
——
fee.
29
An
ambulatory
surgical
center
license
shall
be
obtained
from
30
the
department.
Applications
for
a
license
shall
be
upon
such
31
forms
and
shall
include
such
information
as
the
department
may
32
reasonably
require,
which
may
include
affirmative
evidence
33
of
compliance
with
this
chapter,
other
statutes,
and
rules
34
as
may
be
applicable.
Each
application
for
license
shall
be
35
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_____
accompanied
by
the
required
license
fee
which
shall
be
credited
1
to
the
general
fund
of
the
state.
The
initial
and
annual
2
license
fee
shall
be
five
hundred
dollars.
3
Sec.
6.
NEW
SECTION
.
135P.5
Issuance
and
renewal
of
4
license.
5
1.
Upon
receipt
of
an
application
for
license
and
the
6
license
fee,
the
department
shall
issue
a
license
if
the
7
applicant
and
the
ambulatory
surgical
center
comply
with
this
8
chapter
and
the
rules
of
the
department.
The
department
shall
9
renew
a
license
upon
payment
of
the
five
hundred
dollar
annual
10
license
fee
and
filing
of
an
application
form
available
from
11
the
department.
12
2.
A
license
shall
be
either
general
or
restricted
in
form.
13
A
license
shall
be
issued
only
for
the
premises
and
persons
14
or
governmental
units
named
in
the
application
and
is
not
15
transferable
or
assignable
except
with
the
written
approval
of
16
the
department.
A
license
shall
be
posted
in
a
conspicuous
17
place
on
the
licensed
premises
as
prescribed
by
rule
of
the
18
department.
19
Sec.
7.
NEW
SECTION
.
135P.6
Denial,
suspension,
or
20
revocation
of
license
——
hearings
and
review.
21
1.
The
department
may
deny,
suspend,
or
revoke
a
license
22
in
any
case
where
it
finds
that
there
has
been
a
substantial
23
failure
to
comply
with
this
chapter
or
the
rules
or
minimum
24
standards
adopted
pursuant
to
this
chapter.
25
2.
The
procedure
governing
notice
and
hearing
to
deny
26
an
application
or
suspend
or
revoke
a
license
shall
be
in
27
accordance
with
the
rules
adopted
by
the
department.
A
full
28
and
complete
record
shall
be
kept
of
the
proceedings
and
of
29
any
testimony.
The
record
of
any
proceeding
pursuant
to
this
30
section
need
not
be
transcribed
unless
judicial
review
is
31
sought.
A
copy
or
copies
of
the
transcript
may
be
obtained
by
32
an
interested
party
on
payment
of
the
cost
of
preparing
the
33
copy
or
copies.
34
Sec.
8.
NEW
SECTION
.
135P.7
Rules.
35
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1.
The
department
shall
adopt
rules
setting
out
the
1
standards
for
ambulatory
surgical
centers
to
be
licensed
under
2
this
chapter.
The
rules
shall
state,
at
a
minimum,
that
an
3
ambulatory
surgical
center
shall
meet
the
federal
requirements
4
for
conditions
of
participation
in
the
federal
Medicare
program
5
for
ambulatory
surgical
centers
under
42
C.F.R.
pt.
416.
6
2.
The
department
shall
adopt
rules
to
govern
the
notice
7
and
hearing
procedure
when
a
license
is
denied,
suspended,
or
8
revoked.
9
3.
The
rules
shall
require
ambulatory
surgical
centers
10
to
report
ambulatory
data
to
the
department
of
public
health
11
or
the
designated
intermediary
for
the
purpose
of
public
12
dissemination
of
health
data
as
initially
authorized
in
1996
13
Iowa
Acts,
chapter
1212,
section
5,
subsection
1,
paragraph
“a”
,
14
subparagraph
(4).
15
4.
An
ambulatory
surgical
center
which
is
in
operation
at
16
the
time
of
promulgation
of
any
applicable
rules
or
minimum
17
standards
under
this
chapter
shall
be
given
a
reasonable
time,
18
not
to
exceed
one
year
from
the
date
of
promulgation,
within
19
which
to
comply
with
such
rules
and
minimum
standards.
20
5.
The
department
shall
enforce
the
rules.
21
Sec.
9.
NEW
SECTION
.
135P.8
Inspections.
22
1.
The
department
shall
make
or
cause
to
be
made
inspections
23
or
complaint
investigations
of
ambulatory
surgical
centers
as
24
the
department
deems
necessary
in
order
to
determine
compliance
25
with
this
chapter
and
applicable
rules.
26
2.
A
department
inspector
shall
not
participate
in
an
27
inspection
or
complaint
investigation
of
an
ambulatory
surgical
28
center
in
which
the
inspector
or
a
member
of
the
inspector’s
29
immediate
family
works
or
has
worked
within
the
last
two
years
30
or
in
which
the
inspector
or
the
inspector’s
immediate
family
31
has
a
financial
ownership
interest.
For
the
purposes
of
this
32
section,
“immediate
family
member”
means
a
spouse,
natural
or
33
adoptive
parent
or
grandparent,
child,
grandchild,
sibling,
34
stepparent,
stepchild,
or
stepsibling.
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Sec.
10.
NEW
SECTION
.
135P.9
Employee
background
checks.
1
1.
An
ambulatory
surgical
center
shall
comply
with
child
or
2
dependent
adult
abuse
information
and
criminal
record
checks
3
and
evaluations
as
provided
in
section
135C.33.
4
2.
An
ambulatory
surgical
center
licensed
in
this
state
5
may
access
the
single
contact
repository
established
by
the
6
department
pursuant
to
section
135C.33
as
necessary
for
the
7
ambulatory
surgical
center
to
perform
record
checks
of
persons
8
employed
or
being
considered
for
employment
by
the
ambulatory
9
surgical
center.
10
Sec.
11.
NEW
SECTION
.
135P.10
Confidentiality.
11
The
department’s
final
inspection
or
investigation
findings
12
or
the
final
survey
findings
of
an
accrediting
body,
authorized
13
by
the
department
in
rule,
with
respect
to
compliance
by
an
14
ambulatory
surgical
center
with
requirements
for
licensing
15
or
accreditation
shall
be
made
available
to
the
public
in
a
16
readily
available
form
and
place.
Other
information
relating
17
to
an
ambulatory
surgical
center
obtained
by
the
department
18
which
does
not
constitute
the
department’s
findings
from
an
19
inspection
or
investigation
of
the
ambulatory
surgical
center
20
or
the
final
survey
findings
of
the
accrediting
body
shall
21
not
be
made
available
to
the
public,
except
in
proceedings
22
involving
the
denial,
suspension,
or
revocation
of
a
license
23
under
this
chapter.
The
name
of
a
person
who
files
a
complaint
24
with
the
department
shall
remain
confidential
and
shall
not
25
be
subject
to
discovery,
subpoena,
or
other
means
of
legal
26
compulsion
for
its
release
to
a
person
other
than
department
27
employees
or
agents
involved
in
the
investigation
of
the
28
complaint.
29
Sec.
12.
NEW
SECTION
.
135P.11
Judicial
review.
30
Judicial
review
of
an
action
of
the
department
may
be
sought
31
in
accordance
with
chapter
17A.
Notwithstanding
the
provisions
32
of
chapter
17A,
petitions
for
judicial
review
may
be
filed
33
in
the
district
court
of
the
county
in
which
the
ambulatory
34
surgical
center
is
located
or
to
be
located
and
the
status
quo
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of
the
petitioner
or
licensee
shall
be
preserved
pending
final
1
disposition
of
the
judicial
review
matter.
2
Sec.
13.
NEW
SECTION
.
135P.12
Penalty.
3
Any
person
establishing,
conducting,
managing,
or
operating
4
any
ambulatory
surgical
center
without
a
license
commits
a
5
serious
misdemeanor,
and
each
day
of
continuing
violation
after
6
conviction
shall
be
considered
a
separate
offense.
7
Sec.
14.
NEW
SECTION
.
135P.13
Injunction.
8
Notwithstanding
the
existence
or
pursuit
of
any
other
9
remedy,
the
department
may,
in
the
manner
provided
by
law,
10
maintain
an
action
in
the
name
of
the
state
for
injunction
11
or
other
process
against
any
person
or
governmental
unit
to
12
restrain
or
prevent
the
establishment,
conduct,
management,
or
13
operation
of
an
ambulatory
surgical
center
without
a
license.
14
Sec.
15.
EFFECTIVE
DATE.
This
Act
takes
effect
July
1,
15
2013.
16
EXPLANATION
17
This
bill
relates
to
ambulatory
surgical
centers.
The
bill
18
defines
“ambulatory
surgical
center”
using
the
definition
19
provided
by
Medicare.
The
bill
states
the
purpose
of
new
Code
20
chapter
135P
is
to
protect
public
health,
safety,
and
welfare
21
by
providing
basic
standards
for
operating,
constructing,
and
22
maintaining
an
ambulatory
surgical
center.
23
The
bill
requires
that
any
person
or
governmental
unit
24
acting
separately
or
together
that
establishes,
conducts,
or
25
maintains
an
ambulatory
surgical
center
must
have
a
license
as
26
provided
under
the
Code
chapter.
The
person
or
governmental
27
unit
shall
obtain
a
license
from
the
department
of
inspections
28
and
appeals
(DIA).
The
application
shall
include
information
29
that
the
DIA
may
reasonably
require
including
affirmative
30
evidence
of
compliance
with
new
Code
chapter
135P,
other
31
statutes,
and
rules.
An
application
must
be
accompanied
by
the
32
required
initial
license
fee
of
$500.
An
annual
license
fee
is
33
also
$500.
The
license
fees
are
to
be
credited
to
the
state’s
34
general
fund.
The
bill
also
provides
that
the
DIA
shall
issue
35
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a
license
upon
receiving
an
application
if
the
applicant
1
and
the
ambulatory
surgical
center
comply
with
Code
chapter
2
135P
and
the
rules
of
the
department.
A
licensee
receives
3
reapproval
upon
payment
of
the
$500
license
fee
and
filing
4
an
application
form
available
from
the
DIA.
Licenses
are
5
general
or
restricted
in
form.
A
license
will
be
issued
only
6
for
a
premises
and
persons
or
governmental
units
named
in
the
7
application
and
the
license
is
not
transferable
or
assignable
8
without
written
approval
of
the
DIA.
The
bill
requires
that
9
a
license
be
posted
in
a
conspicuous
place
on
the
licensed
10
premises
as
prescribed
by
department
rules.
11
The
bill
states
that
the
DIA
may
deny,
suspend,
or
revoke
a
12
license
when
it
finds
the
licensee
or
applicant
substantially
13
failed
to
comply
with
Code
chapter
135P
or
rules
or
minimum
14
standards
adopted
pursuant
to
the
Code
chapter.
The
bill
15
states
that
the
DIA
rules
will
govern
the
procedure
for
notice
16
and
hearing
to
deny
an
application
for
a
license
or
to
revoke
17
or
suspend
a
license.
The
bill
states
a
full
and
complete
18
record
of
the
proceedings
shall
be
kept,
but
the
record
does
19
not
need
to
be
transcribed
unless
judicial
review
is
sought.
A
20
transcript
of
the
proceeding
may
be
obtained
by
an
interested
21
party
on
payment
of
the
cost
of
preparing
the
copy
or
copies.
22
The
bill
provides
that
the
DIA
shall
adopt
rules
setting
23
the
standards
for
an
ambulatory
surgical
center
to
be
licensed
24
under
the
Code
chapter.
The
rules
must
require
that
an
25
ambulatory
surgical
center
shall
meet
the
federal
requirements
26
for
conditions
of
participation
in
the
federal
Medicare
27
program
for
ambulatory
surgical
centers
under
42
C.F.R.
28
pt.
416.
The
DIA
must
also
establish,
by
rule,
the
notice
29
and
hearing
procedure
if
a
license
is
denied,
revoked,
or
30
suspended.
The
DIA
must
also
enforce
the
rules.
The
rules
31
established
by
the
DIA
shall
require
ambulatory
surgical
32
centers
to
report
ambulatory
data
to
the
department
of
public
33
health
or
the
designated
intermediary
for
purposes
of
public
34
health
dissemination
of
health
data.
The
bill
states
that
35
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an
ambulatory
surgical
center
in
operation
at
the
time
of
1
promulgation
of
applicable
rules
or
standards
under
Code
2
chapter
135P
shall
be
given
a
reasonable
time,
not
to
exceed
3
one
year,
to
comply
with
the
rules
and
minimum
standards.
4
The
bill
provides
for
inspections
of
ambulatory
surgical
5
centers.
The
bill
requires
the
DIA
to
make,
or
cause
to
be
6
made,
inspections
or
complaint
investigations
as
the
DIA
deems
7
necessary
to
determine
compliance
with
Code
chapter
135P
and
8
the
applicable
rules.
The
DIA
inspectors
must
not
participate
9
in
an
inspection
or
complaint
investigation
of
an
ambulatory
10
surgical
center
if
the
inspector
or
a
member
of
the
inspector’s
11
immediate
family
works
or
has
worked
at
the
ambulatory
surgical
12
center
within
the
last
two
years.
A
DIA
inspector
also
must
13
not
participate
in
an
inspection
or
complaint
investigation
14
of
an
ambulatory
surgical
center
in
which
the
inspector
or
15
the
inspector’s
immediate
family
has
a
financial
or
ownership
16
interest.
17
The
bill
provides
that
an
ambulatory
surgical
center
shall
18
comply
with
abuse
and
criminal
background
checks
as
provided
19
in
Code
section
135C.33.
The
bill
also
states
that
a
licensed
20
ambulatory
surgical
center
is
allowed
to
access
the
single
21
contact
repository
as
is
necessary
to
perform
record
checks
of
22
employees
or
potential
employees.
23
The
bill
provides
for
the
confidentiality
of
the
DIA
records
24
of
ambulatory
surgical
centers.
The
bill
states
that
the
DIA’s
25
final
inspection
or
investigation
findings,
or
survey
findings
26
of
an
accredited
body
authorized
by
the
DIA
rules,
regarding
27
an
ambulatory
surgical
center’s
compliance
with
requirements
28
for
licensing
or
accreditation
must
be
made
available
to
the
29
public
in
a
readily
available
form
and
place.
The
bill
states
30
that
other
information
acquired
by
the
DIA
relating
to
an
31
ambulatory
surgical
center
shall
not
be
made
available
to
the
32
public
except
in
proceedings
involving
denial,
suspension,
33
or
revocation
of
a
license.
The
bill
also
provides
that
the
34
name
of
a
person
who
files
a
complaint
with
the
DIA
shall
35
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remain
confidential
regardless
of
means
of
legal
compulsion
1
for
its
release,
other
than
the
release
of
the
name
to
the
DIA
2
employees
or
agents
involved
in
investigating
a
complaint.
3
The
bill
provides
that
judicial
review
may
be
sought
4
pursuant
to
Code
chapter
17A,
but
petitions
for
judicial
review
5
may
be
filed
in
the
district
court
of
the
county
in
which
the
6
ambulatory
surgical
center
is
located
or
is
to
be
located,
7
notwithstanding
the
terms
of
Code
chapter
17A.
The
bill
8
provides
that
the
status
quo
of
the
petitioner
or
licensee
is
9
preserved
pending
final
disposition
in
court.
10
The
bill
establishes
a
penalty
for
any
person
establishing,
11
conducting,
managing,
or
operating
an
ambulatory
surgical
12
center
without
a
license.
The
person
is
guilty
of
a
serious
13
misdemeanor
and
each
day
of
the
continuing
violation
after
a
14
conviction
is
a
separate
offense.
15
The
bill
provides
that
the
DIA
may
maintain
an
action
in
16
the
name
of
the
state
for
an
injunction
or
other
process
17
against
a
person
or
governmental
unit
to
restrain
or
prevent
18
the
establishment,
conduct,
management,
or
operation
of
an
19
unlicensed
ambulatory
surgical
center.
20
The
bill
provides
that
the
Act
takes
effect
July
1,
2013.
21
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