Bill Summary – FastDemocracy

Senate File 275 - Introduced
                                  SENATE FILE 275
                                  BY ROZENBOOM
                                  (COMPANION TO HF 117 BY BRINK)
                            A BILL FOR
An Act relating to the licensure of ambulatory surgical
  centers, providing for fees to be considered repayment
  receipts, and providing penalties.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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    Section 1. NEW SECTION. 135Q.1 Definitions.
    As used in this chapter, unless the context otherwise
 requires:
    1. “Ambulatory surgical center” means a distinct facility
 that operates exclusively for the purpose of providing surgical
 services to patients not requiring hospitalization and in which
 the expected duration of services does not exceed twenty-four
 hours following an admission. “Ambulatory surgical center”
 includes a facility that otherwise meets the definition of an
 ambulatory surgical center whether or not licensed, certified,
 or accredited as an ambulatory surgical center and which may
 or may not operate on a partially cash-only or completely
 cash-only basis. “Ambulatory surgical center” does not include
 individual or group practice offices of private physicians
 or podiatrists that do not contain a distinct area used for
 outpatient surgical treatment on a regular basis, or that
 only provide surgery routinely provided in a physician’s
 or podiatrist’s office using local anesthesia or conscious
 sedation; individual or group practice offices of private
 dentists; or a portion of a licensed hospital designated for
 outpatient surgical treatment.
    2. “Department” means the department of inspections and
 appeals.
    Sec. 2. NEW SECTION. 135Q.2 Purpose.
    The purposes of this chapter is to protect the public
 health, safety, and welfare by providing for the licensing and
 regulation of ambulatory surgical centers.
    Sec. 3. NEW SECTION. 135Q.3 Licenses —— application —— fees
 —— expiration and renewal.
    1. A person, acting severally or jointly with any other
 person shall not establish, operate, or maintain an ambulatory
 surgical center in this state without first meeting the
 requirements and obtaining a license as provided in this
 chapter.
    2. a. An application for a license shall be on a form
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 prescribed by the department and shall require information the
 department deems necessary. An application for an initial
 license for an ambulatory surgical center shall be accompanied
 by a nonrefundable fee of fifty dollars. The fees collected
 under this section shall be considered repayment receipts as
 defined in section 8.2 and shall be used by the department to
 administer this chapter.
    b. The ambulatory surgical center shall meet the criteria
 adopted by rule of the department pursuant to section 135Q.5
 before a license is issued. The department is responsible
 to provide the necessary personnel to inspect the ambulatory
 surgical center to determine if the ambulatory surgical center
 complies with necessary standards before a license is issued.
    3. An ambulatory surgical center certified under the
 Medicare program or accredited by an accrediting organization
 authorized by the centers for Medicare and Medicaid services
 with deeming authority, shall be licensed without inspection by
 the department as provided in section 135Q.6.
    4. A license shall be issued only for the premises and
 persons named in the application.
    5. A license is not transferable or assignable except with
 the written approval of the department.
    6. A license shall be posted in a conspicuous place on the
 licensed premises as prescribed by rule of the department.
    7. Separate licenses are not required for ambulatory
 surgical center facilities that are maintained on the same
 physical site and that have the same ownership or control.
 Multiple buildings located on the same physical site under the
 same ownership or control shall be considered one ambulatory
 surgical center and may operate under one license.
    8. A license, unless sooner suspended or revoked, shall
 expire on June 30 of each year and shall be renewed annually.
 The department shall renew a license upon payment of a fifty
 dollar annual license renewal fee and filing of an application
 for renewal at least thirty days prior to the expiration of the
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                                S.F. 275
 existing license. The annual licensure fee shall be considered
 a repayment receipt as defined in section 8.2 and dedicated to
 support the staffing necessary to conduct the inspections and
 investigations provided in section 135Q.6.
    Sec. 4. NEW SECTION. 135Q.4 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 there has been a substantial failure
 to comply with this chapter or the rules and standards adopted
 under this chapter.
    2. The denial, suspension, or revocation of a license by
 the department and appeal from that action are governed by the
 procedures for a contested case hearing under chapter 17A.
    3. a. If the department finds, after providing notice of
 noncompliance and a reasonable time for corrective action, that
 an ambulatory surgical center is in repeated noncompliance with
 this chapter or the department’s rules but that noncompliance
 does not endanger public health or safety, the department may
 issue a conditional license to the ambulatory surgical center
 as an alternative to suspending or revoking the ambulatory
 surgical center’s license.
    b. The department shall provide notice of its intent to
 issue a conditional license to the ambulatory surgical center
 and of the items of noncompliance not less than ten days before
 the date the conditional license is issued.
    c. The department shall designate a period of not more
 than one year during which the ambulatory surgical center may
 operate under a conditional license.
    d. During the period an ambulatory surgical center is
 operating under a conditional license, the ambulatory surgical
 center shall correct the items that are in noncompliance and
 report the corrections to the department for approval.
    4. The department may suspend or revoke the license of an
 ambulatory surgical center that does not correct items that
 are in noncompliance or that does not comply with this chapter
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 or the rules adopted under this chapter within the applicable
 period.
    5. The department may issue an emergency order to suspend
 a license issued under this chapter if the department has
 reasonable cause to believe that the conduct of the ambulatory
 surgical center creates an immediate danger to the public
 health and safety. An emergency suspension is effective
 immediately without a hearing or notice to the licensee. On
 written request of the licensee, the department shall conduct
 a hearing not earlier than the tenth day or later than the
 thirtieth day after the date the hearing request is received
 to determine if the emergency suspension is to be continued,
 modified, or rescinded. The hearing and any appeal are
 governed by the department’s rules for a contested case hearing
 and chapter 17A.
    Sec. 5. NEW SECTION. 135Q.5 Rules.
    1. The department, with the advice and approval of the state
 board of health, shall adopt rules specifying the standards
 for ambulatory surgical centers to be licensed under this
 chapter. The rules and standards shall be consistent with 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 including those related to
 the administration of anesthesia and to a safe and sanitary
 environment in which to perform surgical procedures.
    2. The department shall adopt rules as the department deems
 necessary to implement the provisions of this chapter relating
 to the issuance, renewal, denial, suspension, and revocation
 of a license to establish, operate, and maintain an ambulatory
 surgical center.
    3. An ambulatory surgical center which is in operation at
 the time of adoption of any applicable rules or standards under
 this chapter shall be given a reasonable time, not to exceed
 one year from the date of adoption, within which to comply with
 such rules and standards.
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    Sec. 6. NEW SECTION. 135Q.6 Inspections or investigations.
    1. The department shall make or cause to be made inspections
 or investigations of ambulatory surgical centers to determine
 compliance with this chapter and applicable rules and
 standards. The department shall perform inspections on a
 schedule that is of the same frequency required for inspections
 of Medicare-certified ambulatory surgical centers.
    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 completed
 by the department, or an accrediting organization authorized by
 the centers for Medicare and Medicaid services of the United
 States department of health and human services.
    3. A department inspector shall not participate in an
 inspection or 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. 7. NEW SECTION. 135Q.7 Ambulatory surgical center
 employees —— criminal history and abuse record checks.
    The department shall adopt rules pursuant to chapter 17A
 to provide for the performance of criminal record checks and
 founded child abuse or dependent adult abuse record checks
 applicable to prospective employees of an ambulatory surgical
 center in substantial conformance with the provisions of
 section 135B.34 and section 135C.33.
    Sec. 8. NEW SECTION. 135Q.8 Confidentiality.
    The department’s final findings with respect to compliance
 by an ambulatory surgical center with requirements for
 licensing shall be made available to the public in a readily
 available form and place. Other information relating to
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 an ambulatory surgical center obtained by the department
 which does not constitute the department’s findings from an
 inspection of the ambulatory surgical center 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. 9. NEW SECTION. 135Q.9 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 to restrain or prevent
 the establishment, operation, or maintenance of an ambulatory
 surgical center without a license.
    Sec. 10. NEW SECTION. 135Q.10 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 is to be located and the status
 quo of the petitioner or licensee shall be preserved pending
 final disposition of the judicial review matter.
    Sec. 11. NEW SECTION. 135Q.11 Penalties.
    Any person establishing, operating, or maintaining 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.
                            EXPLANATION
         The inclusion of this explanation does not constitute agreement with
          the explanation’s substance by the members of the general assembly.
  This bill creates a new Code chapter to provide for the
licensing and regulation of ambulatory surgical centers.
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    The bill defines “ambulatory surgical center” as a distinct
 facility that operates exclusively for the purpose of providing
 surgical services to patients not requiring hospitalization
 and in which the expected duration of services does not exceed
 24 hours following an admission. “Ambulatory surgical center”
 includes a facility that otherwise meets the definition of an
 ambulatory surgical center whether or not licensed, certified,
 or accredited as an ambulatory surgical center and which may
 or may not operate on a partially cash-only or completely
 cash-only basis. “Ambulatory surgical center” does not include
 individual or group practice offices of private physicians
 or podiatrists that do not contain a distinct area used for
 outpatient surgical treatment on a regular basis, or that
 only provide surgery routinely provided in a physician’s
 or podiatrist’s office using local anesthesia or conscious
 sedation; individual or group practice offices of dentists;
 or a portion of a licensed hospital designated for outpatient
 surgical treatment.
    The bill prohibits the establishment, operation, or
 maintenance of an ambulatory surgical center in the state
 without meeting the requirements of the new Code chapter and
 obtaining a license.
    The bill provides for the application for licensure, the
 issuance and renewal of a license, and the denial, suspension,
 or revocation of a license, and the associated processes, and
 for the imposition and payment of associated fees.
    The bill directs the department of inspections and appeals
 (DIA) to adopt rules with the advice and approval of the
 state board of health to specify the standards for ambulatory
 surgical centers. The rules and standards are required to be
 consistent with the requirements of the Code chapter and the
 conditions for coverage in the federal Medicare program for
 ambulatory surgical centers. DIA is also directed to adopt
 rules relating to the issuance, renewal, denial, suspension,
 and revocation of a license to establish, operate, and
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 maintain an ambulatory surgical center. If an ambulatory
 surgical center is in operation at the time of adoption of
 any applicable rules or standards, the center is to be given
 a reasonable time, not to exceed one year from the date of
 adoption, within which to comply with such rules and standards.
    The bill provides for inspections or investigations of
 ambulatory surgical centers, and directs that the DIA shall
 perform inspections on a schedule that is of the same frequency
 required for inspections of Medicare-certified ambulatory
 surgical centers. The bill also requires the DIA to recognize,
 in lieu of its own licensure inspection, the comparable
 inspection and inspection findings of a Medicare conditions
 for coverage survey completed by the department or a national
 accreditation agency authorized by the centers for Medicare and
 Medicaid services of the United States department of health and
 human services.
    The bill prohibits a DIA inspector from participating in an
 inspection or investigation of an ambulatory surgical center in
 which the inspector or a member of the inspector’s immediate
 family works or has worked wit