SENATE FILE 40

BY  JOHNSON, SORENSON, FEENSTRA, ANDERSON, ZAUN, BOETTGER, SEYMOUR, and BEHN

A BILL FOR

An Act relating to the definition and regulation of outpatient surgical facilities or ambulatory surgical centers and providing for fees.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

   Section 1.  Section 135.61, subsection 21, Code 2011, is amended to read as follows:
   21.  “Outpatient surgical facility” means a any of the following:
   a.  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 not a part of a hospital nor is owned wholly or in part by a hospital.“Outpatient surgical facility” also does not include the private office of a health care provider who there engages in the lawful practice of surgery. “Outpatient surgical facility” includes a
   b.  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.
   c.  A facility that provides for the performing or inducing of any second or third trimester abortions or five or more first trimester abortions per month.
   Sec. 2.  NEW SECTION.  135P.1  Definitions.
   As used in this chapter, unless the context otherwise requires:
   1.  “Ambulatory surgical center” means an outpatient surgical facility as defined in section 135.61 or an ambulatory surgical facility as defined in section 514.5.
   2.  “Department” means the department of inspections and appeals.
   Sec. 3.  NEW SECTION.  135P.2  Licenses—— fees—— criteria.
   1.  A person shall not operate an ambulatory surgical center in this state without first obtaining a license from the department after meeting the requirements of this chapter. The application shall be on a form prescribed by the department and shall require information the department deems necessary. Each application for license shall be accompanied by a nonrefundable biennial license fee determined by the department.
   2.  The ambulatory surgical center shall meet the requirements of 42 C.F.R. § 416 before a license is issued. The department shall provide the necessary personnel to inspect the ambulatory surgical center to determine if the ambulatory surgical center complies with necessary requirements before a license is issued. An ambulatory surgical center that is certified under the federal Medicare program and thereby meets the requirements of 42 C.F.R. § 416 shall be licensed without inspection by the department.
   Sec. 4.  NEW SECTION.  135P.3  Denial, suspension, or revocation of license.
   The department may deny, suspend, or revoke a license if the department determines an ambulatory surgical center fails to comply with this chapter or the rules adopted under this chapter. A denial, suspension, or revocation may be appealed under chapter 17A. The department may reissue a license following a suspension or revocation after the ambulatory surgical center corrects the conditions upon which the suspension or revocation was based.
   Sec. 5.  NEW SECTION.  135P.4  Limitation, expiration, and renewal of license.
   A license for an ambulatory surgical center shall be issued only for the premises, person, or facility named in the application and is not transferable or assignable. A license, unless sooner suspended or revoked, shall expire two years after the date of issuance and shall be renewed biennially upon an application by the licensee. Application for renewal shall be made in writing to the department at least thirty days prior to the expiration of the license. The fee for a license renewal shall be determined by the department.
   Sec. 6.  NEW SECTION.  135P.5  Rules.
   Except as otherwise provided in this chapter, the department shall adopt rules pursuant to chapter 17A necessary to implement this chapter, subject to approval of the state board of health. Formulation of the rules shall include consultation with persons affected by this chapter.
   Sec. 7.  Section 514.5, Code 2011, is amended to read as follows:
   514.5  Contracts for service.
   1.  A hospital service corporation organized under chapter 504, Code 1989, or current chapter 504 may enter into contracts for the rendering of hospital service to any of its subscribers with hospitals maintained and operated by the state or any of its political subdivisions, or by any corporation, association, or individual. Such hospital service corporation may also contract with an ambulatory surgical facility to provide surgical services to the corporation’s subscribers. Hospital service is meant to include bed and board, general nursing care, use of the operating room, use of the delivery room, ordinary medications and dressings and other customary routine care.“Ambulatory surgical facility” means a facility constructed and operated for the specific purpose of providing surgery to patients admitted to and discharged from the facility within the same day or an“outpatient surgical facility” as defined in section 135.61.
   2.  A medical service corporation organized under this chapter may enter into contracts with subscribers to furnish health care service through physicians and surgeons, dentists, podiatric physicians, osteopathic physicians, osteopathic physicians and surgeons, or chiropractors.
   3.  Any pharmaceutical or optometric service corporation organized under the provisions of said chapter may enter into contracts for the rendering of pharmaceutical or optometric service to any of its subscribers. Membership in any pharmaceutical service corporation shall be open to all pharmacies licensed under chapter 155A.
   4.  A hospital service corporation or medical service corporation organized under this chapter may enter into contracts with subscribers and providers to furnish health care services not otherwise allocated by this section.
EXPLANATION
   This bill defines an outpatient surgical facility or ambulatory surgical center to include any facility that provides for performing or inducing any second or third trimester abortions or five or more first trimester abortions per month, thereby making these establishments subject to certificate of need requirements and other regulatory provisions to which outpatient surgical facilities or ambulatory surgical centers are subject. The bill also amends the definition of an outpatient surgical facility to exclude facilities that are owned wholly or in part by a hospital.
   The bill also requires that ambulatory surgical centers be licensed and meet the requirements of the centers for Medicare and Medicaid services of the United States department of health and human services for ambulatory surgical centers.