S.F. _____ Section 1. Section 10A.711, subsection 2, Code 2024, is 1 amended to read as follows: 2 2. “Ambulatory surgical center” means ambulatory surgical 3 center as defined in section 135R.1 a distinct facility that 4 operates primarily 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 an 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 Sec. 2. Section 10A.713, subsection 2, Code 2024, is amended 17 by adding the following new paragraph: 18 NEW PARAGRAPH . q. Cosmetic, reconstructive, or plastic 19 surgery services provided in an ambulatory surgical center 20 licensed under chapter 135R. 21 Sec. 3. Section 135R.3, subsection 1, Code 2024, is amended 22 to read as follows: 23 1. An applicant for an ambulatory surgical center license 24 shall submit an application to the department. Applications 25 shall be upon such forms and shall include such information 26 as the department may reasonably require, which may include 27 affirmative evidence of the ability to comply with reasonable 28 rules and standards prescribed under this chapter but which 29 shall not exceed either the requirements for applications 30 required by Medicare , or an accreditation standard for the 31 joint commission, the American association for accreditation of 32 ambulatory surgical facilities, the accreditation association 33 for ambulatory health care, or an accrediting organization with 34 deeming authority authorized by the centers for Medicare and 35 -1- LSB 5760XC (5) 90 pf/ko 1/ 3

S.F. _____ Medicaid services of the United States department of health and 1 human services. 2 Sec. 4. Section 135R.5, subsection 2, Code 2024, is amended 3 to read as follows: 4 2. The department shall recognize, in lieu of its own 5 licensure inspection, the comparable inspection and inspection 6 findings of a Medicare conditions for coverage survey completed 7 by the department or an accrediting organization survey from an 8 accrediting organization with deeming authority authorized by 9 the centers for Medicare and Medicaid services of the United 10 States department of health and human services. An ambulatory 11 surgical center utilizing an accrediting organization survey 12 to satisfy the requirements of this section shall submit an 13 accreditation certificate to the department within thirty days 14 of completion of each accrediting organization survey. 15 EXPLANATION 16 The inclusion of this explanation does not constitute agreement with 17 the explanation’s substance by the members of the general assembly. 18 This bill relates to ambulatory surgical centers (ASCs). 19 The bill defines “ambulatory surgical center” differently 20 for the purposes of Code chapter 10A (department of 21 inspections, appeals, and licensing) relative to the health 22 facilities council and certificate of need as compared with 23 Code chapter 135R (ambulatory surgical centers). Under Code 24 section 10A.711, “ambulatory surgical center” does not include 25 the individual or group practice office of a private physician, 26 podiatrist, or dentist who there engages in the lawful practice 27 of surgery, or the portion of a licensed hospital designated 28 for outpatient surgical treatment. Under Code section 135R.1, 29 “ambulatory surgical center” does not include the individual or 30 group practice office of a private physician, podiatrist, or 31 dentist who there engages in the lawful practice of surgery, 32 not including cosmetic, reconstructive, or plastic surgery, or 33 the portion of a licensed hospital designated for outpatient 34 surgical treatment. 35 -2- LSB 5760XC (5) 90 pf/ko 2/ 3

S.F. _____ The bill also exempts from the applicability of certificate 1 of need requirements, cosmetic, reconstructive, or plastic 2 surgery services provided in an ambulatory surgical center as 3 defined in Code section 135R.1, and as licensed pursuant to 4 Code chapter 135R. 5 The bill amends Code section 135R.3(1) to provide that the 6 application requirements for an ASC license shall not exceed 7 either the requirements for applications required by Medicare, 8 or an accreditation standard for the joint commission, the 9 American association for accreditation of ambulatory surgical 10 facilities, the accreditation association for ambulatory health 11 care, or an accrediting organization with deeming authority 12 authorized by the centers for Medicare and Medicaid services 13 (CMS) of the United States department of health and human 14 services. 15 Code section 135R.5(2) provides that the department of 16 inspections, appeals, and licensing (DIAL) shall recognize, in 17 lieu of its own licensure inspection, the comparable inspection 18 and inspections findings of a Medicare conditions survey 19 completed by DIAL or an accrediting organization with deeming 20 authority authorized by CMS. The bill provides instead that 21 DIAL shall recognize the comparable inspection and inspections 22 findings of a Medicare conditions survey completed by DIAL 23 or an accrediting organization survey from an accrediting 24 organization with deeming authority authorized by CMS. An ASC 25 utilizing an accrediting organization survey as specified shall 26 submit an accreditation certificate to DIAL within 30 days of 27 completion of each accrediting organization survey. 28 -3- LSB 5760XC (5) 90 pf/ko 3/ 3