SF 2271 (LSB 5348SV (5) 84)

SENATE FILE 2271

BY  COMMITTEE ON STATE GOVERNMENT

(SUCCESSOR TO SSB 3021)

A BILL FOR

An Act relating to the licensure of ambulatory surgical centers, providing fees and penalties, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  135P.1  Definitions.
   1.  “Ambulatory surgical center” means a facility which as its primary function provides, through an organized medical staff and on an outpatient basis to patients who are generally ambulatory, surgical procedures not ordinarily performed in a private physician’s office, but not requiring twenty-four-hour hospitalization, and which is neither a part of a hospital nor the private office of a health care provider who there engages in the lawful practice of surgery. “Ambulatory surgical center” includes a facility certified or seeking certification as an ambulatory surgical center under the federal Medicare program or under the medical assistance program established pursuant to chapter 249A. “Ambulatory surgical center” does not include a facility operated by a person licensed to practice dentistry pursuant to chapter 153.
   2.  “Department” means the department of inspections and appeals.
   3.  “Governmental unit” means the state, or any county, municipality, or other political subdivision, or any department, division, board, or other agency of any of the foregoing.
    Sec. 2.  NEW SECTION.  135P.2  Purpose.
   The purpose of this chapter is to protect the public health, safety, and welfare by providing for the development, establishment, and enforcement of basic standards for the operation, construction, and maintenance of ambulatory surgical centers.
    Sec. 3.  NEW SECTION.  135P.3  Licensure.
   No person or governmental unit, acting severally or jointly with any other person or governmental unit, shall establish, operate, or maintain an ambulatory surgical center in this state without obtaining a license as provided under this chapter.
    Sec. 4.  NEW SECTION.  135P.4  Application for license —— fee.
   An ambulatory surgical center license shall be obtained from the department. Applications for a license shall be upon such forms and shall include such information as the department may reasonably require, which may include affirmative evidence of compliance with this chapter, other statutes, and rules as may be applicable. Each application for license shall be accompanied by the required license fee which shall be credited to the general fund of the state. The initial and annual license fee shall be five hundred dollars.
    Sec. 5.  NEW SECTION.  135P.5  Issuance and renewal of license.
   1.  Upon receipt of an application for license and the license fee, the department shall issue a license if the applicant and the ambulatory surgical center comply with this chapter and the rules of the department. The department shall renew a license upon payment of the five hundred dollar annual license fee and filing of an application form available from the department.
   2.  A license shall be either general or restricted in form. A license shall be issued only for the premises and persons or governmental units named in the application and is not transferable or assignable except with the written approval of the department. A license shall be posted in a conspicuous place on the licensed premises as prescribed by rule of the department.
    Sec. 6.  NEW SECTION.  135P.6  Denial, suspension, or revocation of license —— hearings and review.
   1.  The department may deny, suspend, or revoke a license in any case where it finds that there has been a substantial failure to comply with this chapter or the rules or minimum standards adopted pursuant to this chapter.
   2.  The procedure governing notice and hearing to deny an application or suspend or revoke a license shall be in accordance with the rules adopted by the department. A full and complete record shall be kept of the proceedings and of any testimony. The record of any proceeding pursuant to this section need not be transcribed unless judicial review is sought. A copy or copies of the transcript may be obtained by an interested party on payment of the cost of preparing the copy or copies.
    Sec. 7.  NEW SECTION.  135P.7  Rules.
   1.  The department shall adopt rules setting out the standards for ambulatory surgical centers to be licensed under this chapter. The rules shall be consistent with and not exceed the requirements of this chapter and the conditions for coverage in the federal Medicare program for ambulatory surgical centers under 42 C.F.R. pt. 416.
   2.  The department shall adopt rules to govern the notice and hearing procedure when a license is denied, suspended, or revoked.
   3.  The rules shall require ambulatory surgical centers to report ambulatory data to the department of public health or the designated intermediary for the purpose of public dissemination of health data as initially authorized in 1996 Iowa Acts, chapter 1212, section 5, subsection 1, paragraph “a”, subparagraph (4).
   4.  An ambulatory surgical center which is in operation at the time of promulgation of any applicable rules or minimum standards under this chapter shall be given a reasonable time, not to exceed one year from the date of promulgation, within which to comply with such rules and minimum standards.
   5.  The department shall enforce the rules.
    Sec. 8.  NEW SECTION.  135P.8  Inspections.
   1.  The department shall make or cause to be made inspections or complaint investigations of ambulatory surgical centers as the department deems necessary in order to determine compliance with this chapter and applicable rules.
   2.  The department shall recognize, in lieu of its own licensure inspection, the comparable inspection and inspection findings of a Medicare conditions for coverage survey.
   3.  A department inspector shall not participate in an inspection or complaint investigation of an ambulatory surgical center in which the inspector or a member of the inspector’s immediate family works or has worked within the last two years or in which the inspector or the inspector’s immediate family has a financial ownership interest. For the purposes of this section, “immediate family member” means a spouse, natural or adoptive parent or grandparent, child, grandchild, sibling, stepparent, stepchild, or stepsibling.
    Sec. 9.  NEW SECTION.  135P.9  Employee background checks.
   1.  An ambulatory surgical center shall comply with child or dependent adult abuse information and criminal record checks and evaluations in the same manner as provided in section 135B.34.
   2.  An ambulatory surgical center licensed in this state may access the single contact repository established by the department pursuant to section 135C.33 as necessary for the ambulatory surgical center to perform record checks of persons employed or being considered for employment by the ambulatory surgical center.
    Sec. 10.  NEW SECTION.  135P.10  Confidentiality.
   The department’s final inspection or investigation findings or the final survey findings of an accrediting body, authorized by the department in rule, with respect to compliance by an ambulatory surgical center with requirements for licensing or accreditation shall be made available to the public in a readily available form and place. Other information relating to an ambulatory surgical center obtained by the department which does not constitute the department’s findings from an inspection or investigation of the ambulatory surgical center or the final survey findings of the accrediting body shall not be made available to the public, except in proceedings involving the denial, suspension, or revocation of a license under this chapter. The name of a person who files a complaint with the department shall remain confidential and shall not be subject to discovery, subpoena, or other means of legal compulsion for its release to a person other than department employees or agents involved in the investigation of the complaint.
    Sec. 11.  NEW SECTION.  135P.11  Judicial review.
   Judicial review of an action of the department may be sought in accordance with chapter 17A. Notwithstanding the provisions of chapter 17A, petitions for judicial review may be filed in the district court of the county in which the ambulatory surgical center is located or to be located and the status quo of the petitioner or licensee shall be preserved pending final disposition of the judicial review matter.
    Sec. 12.  NEW SECTION.  135P.12  Penalty.
   Any person establishing, conducting, managing, or operating any ambulatory surgical center without a license commits a serious misdemeanor, and each day of continuing violation after conviction shall be considered a separate offense.
    Sec. 13.  NEW SECTION.  135P.13  Injunction.
   Notwithstanding the existence or pursuit of any other remedy, the department may, in the manner provided by law, maintain an action in the name of the state for injunction or other process against any person or governmental unit to restrain or prevent the establishment, conduct, management, or operation of an ambulatory surgical center without a license.
    Sec. 14.  WORKGROUP ESTABLISHED —— RULES.  The department of public health shall convene a workgroup with stakeholders and a designated intermediary to determine which fields of information will be utilized in the data reporting requirement pursuant to chapter 135P as enacted in this Act. Any rules adopted by the department of public health regarding the data reporting requirements pursuant to section 135P.7, as enacted in this Act, shall reflect the recommendations of the workgroup.
    Sec. 15.  EFFECTIVE DATE.  This Act takes effect July 1, 2013.
EXPLANATION
   This bill relates to ambulatory surgical centers. The bill defines “ambulatory surgical center” as a facility which primarily provides surgical outpatient procedures that are not ordinarily performed in a private physician’s office but do not require 24-hour hospitalization. The bill provides that an “ambulatory surgical center” includes a facility that is certified or is seeking certification as an ambulatory surgical center under the federal Medicare program or under the medical assistance program established pursuant to Code chapter 249A, but does not include a facility operated by a person licensed to practice dentistry.
   The bill states the purpose of new Code chapter 135P is to protect public health, safety, and welfare by providing basic standards for operating, constructing, and maintaining an ambulatory surgical center. 
   The bill requires that any person or governmental unit acting separately or together that establishes, conducts, or maintains an ambulatory surgical center must have a license as provided under the Code chapter. The person or governmental unit shall obtain a license from the department of inspections and appeals (DIA). The application shall include information that the DIA may reasonably require including affirmative evidence of compliance with new Code chapter 135P, other statutes, and rules. An application must be accompanied by the required initial license fee of $500. An annual license fee is also $500. The license fees are to be credited to the state’s general fund. The bill also provides that the DIA shall issue a license upon receiving an application if the applicant and the ambulatory surgical center comply with Code chapter 135P and the rules of the department. A licensee receives reapproval upon payment of the $500 license fee and filing an application form available from the DIA. Licenses are general or restricted in form. A license will be issued only for a premises and persons or governmental units named in the application and the license is not transferable or assignable without written approval of the DIA. The bill requires that a license be posted in a conspicuous place on the licensed premises as prescribed by department rules. 
   The bill states that the DIA may deny, suspend, or revoke a license when it finds the licensee or applicant substantially failed to comply with Code chapter 135P or rules or minimum standards adopted pursuant to the Code chapter. The bill states that the DIA rules will govern the procedure for notice and hearing to deny an application for a license or to revoke or suspend a license. The bill states a full and complete record of the proceedings shall be kept, but the record does not need to be transcribed unless judicial review is sought. A transcript of the proceeding may be obtained by an interested party on payment of the cost of preparing the copy or copies. 
   The bill provides that the DIA shall adopt rules setting the standards for an ambulatory surgical center to be licensed under the Code chapter. The rules must be consistent with and cannot exceed the requirements of Code chapter 135P or the federal requirements for coverage in the federal Medicare program for ambulatory surgical centers under 42 C.F.R. pt. 416. The DIA must also establish, by rule, the notice and hearing procedure if a license is denied, revoked, or suspended. The DIA must also enforce the rules. The rules established by the DIA shall require ambulatory surgical centers to report ambulatory data to the department of public health or the designated intermediary for purposes of public health dissemination of health data. The bill states that an ambulatory surgical center in operation at the time of promulgation of applicable rules or standards under Code chapter 135P shall be given a reasonable time, not to exceed one year, to comply with the rules and minimum standards. 
   The bill provides for inspections of ambulatory surgical centers. The bill requires the DIA to make, or cause to be made, inspections or complaint investigations as the DIA deems necessary to determine compliance with Code chapter 135P and the applicable rules. The DIA must recognize the comparable inspection and findings of a Medicare conditions for coverage survey in lieu of the DIA’s own licensure inspection.
   The DIA inspectors must not participate in an inspection or complaint investigation of an ambulatory surgical center if the inspector or a member of the inspector’s immediate family works or has worked at the ambulatory surgical center within the last two years. A DIA inspector also must not participate in an inspection or complaint investigation of an ambulatory surgical center in which the inspector or the inspector’s immediate family has a financial or ownership interest.
   The bill provides that an ambulatory surgical center shall comply with abuse and criminal background checks in the same manner as provided in Code section 135B.34. The bill also states that a licensed ambulatory surgical center is allowed to access the single contact repository as is necessary to perform record checks of employees or potential employees. 
   The bill provides for the confidentiality of the DIA records of ambulatory surgical centers. The bill states that the DIA’s final inspection or investigation findings, or survey findings of an accredited body authorized by the DIA rules, regarding an ambulatory surgical center’s compliance with requirements for licensing or accreditation must be made available to the public in a readily available form and place. The bill states that other information acquired by the DIA relating to an ambulatory surgical center shall not be made available to the public except in proceedings involving denial, suspension, or revocation of a license. The bill also provides that the name of a person who files a complaint with the DIA shall remain confidential regardless of means of legal compulsion for its release, other than the release of the name to the DIA employees or agents involved in investigating a complaint. 
   The bill provides that judicial review may be sought pursuant to Code chapter 17A, but petitions for judicial review may be filed in the district court of the county in which the ambulatory surgical center is located or is to be located, notwithstanding the terms of Code chapter 17A. The bill provides that the status quo of the petitioner or licensee is preserved pending final disposition in court. 
   The bill establishes a penalty for any person establishing, conducting, managing, or operating an ambulatory surgical center without a license. The person is guilty of a serious misdemeanor and each day of the continuing violation after a conviction is a separate offense. 
   The bill provides that the DIA may maintain an action in the name of the state for an injunction or other process against a person or governmental unit to restrain or prevent the establishment, conduct, management, or operation of an unlicensed ambulatory surgical center. 
   The bill establishes a workgroup to recommend which fields of information will be utilized for the data reporting requirement provided in Code chapter 135P. The department of public health shall convene the workgroup with stakeholders and a designated intermediary. The bill requires that any rules adopted by the department of public health regarding the data reporting requirement shall reflect the workgroup’s recommendations.
   The bill provides that the Act takes effect July 1, 2013.