Text: HSB520            Text: HSB522


House Study Bill 521

HOUSE FILE BY (PROPOSED COMMITTEE ON STATE GOVERNMENT BILL BY CHAIRPERSON COWNIE) A BILL FOR 1 An Act relating to the licensure of ambulatory surgical 2 centers, providing fees and penalties, and including 3 effective date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: TLSB 5348YC (6) 84 ad/nh PAG LIN 1 1 Section 1. Section 135C.33, subsection 5, paragraph a, Code 1 2 2011, is amended by adding the following new subparagraph: 1 3 NEW SUBPARAGRAPH. (6) An employee of an ambulatory surgical 1 4 center licensed under chapter 135P. 1 5 Sec. 2. NEW SECTION. 135P.1 Definitions. 1 6 1. "Ambulatory surgical center" means any distinct facility 1 7 that operates exclusively for the purpose of providing surgical 1 8 services to patients not requiring hospitalization and in which 1 9 the expected duration of services would not exceed twenty=four 1 10 hours following an admission. 1 11 2. "Department" means the department of inspections and 1 12 appeals. 1 13 3. "Governmental unit" means the state, or any county, 1 14 municipality, or other political subdivision, or any 1 15 department, division, board, or other agency of any of the 1 16 foregoing. 1 17 Sec. 3. NEW SECTION. 135P.2 Purpose. 1 18 The purpose of this chapter is to protect the public 1 19 health, safety, and welfare by providing for the development, 1 20 establishment, and enforcement of basic standards for the 1 21 operation, construction, and maintenance of ambulatory surgical 1 22 centers. 1 23 Sec. 4. NEW SECTION. 135P.3 Licensure. 1 24 No person or governmental unit, acting severally or jointly 1 25 with any other person or governmental unit, shall establish, 1 26 operate, or maintain an ambulatory surgical center in this 1 27 state without obtaining a license as provided under this 1 28 chapter. 1 29 Sec. 5. NEW SECTION. 135P.4 Application for license ==== fee. 1 30 An ambulatory surgical center license shall be obtained from 1 31 the department. Applications for a license shall be upon such 1 32 forms and shall include such information as the department may 1 33 reasonably require, which may include affirmative evidence 1 34 of compliance with this chapter, other statutes, and rules 1 35 as may be applicable. Each application for license shall be 2 1 accompanied by the required license fee which shall be credited 2 2 to the general fund of the state. The initial and annual 2 3 license fee shall be five hundred dollars. 2 4 Sec. 6. NEW SECTION. 135P.5 Issuance and renewal of 2 5 license. 2 6 1. Upon receipt of an application for license and the 2 7 license fee, the department shall issue a license if the 2 8 applicant and the ambulatory surgical center comply with this 2 9 chapter and the rules of the department. The department shall 2 10 renew a license upon payment of the five hundred dollar annual 2 11 license fee and filing of an application form available from 2 12 the department. 2 13 2. A license shall be either general or restricted in form. 2 14 A license shall be issued only for the premises and persons 2 15 or governmental units named in the application and is not 2 16 transferable or assignable except with the written approval of 2 17 the department. A license shall be posted in a conspicuous 2 18 place on the licensed premises as prescribed by rule of the 2 19 department. 2 20 Sec. 7. NEW SECTION. 135P.6 Denial, suspension, or 2 21 revocation of license ==== hearings and review. 2 22 1. The department may deny, suspend, or revoke a license 2 23 in any case where it finds that there has been a substantial 2 24 failure to comply with this chapter or the rules or minimum 2 25 standards adopted pursuant to this chapter. 2 26 2. The procedure governing notice and hearing to deny 2 27 an application or suspend or revoke a license shall be in 2 28 accordance with the rules adopted by the department. A full 2 29 and complete record shall be kept of the proceedings and of 2 30 any testimony. The record of any proceeding pursuant to this 2 31 section need not be transcribed unless judicial review is 2 32 sought. A copy or copies of the transcript may be obtained by 2 33 an interested party on payment of the cost of preparing the 2 34 copy or copies. 2 35 Sec. 8. NEW SECTION. 135P.7 Rules. 3 1 1. The department shall adopt rules setting out the 3 2 standards for ambulatory surgical centers to be licensed under 3 3 this chapter. The rules shall state, at a minimum, that an 3 4 ambulatory surgical center shall meet the federal requirements 3 5 for conditions of participation in the federal Medicare program 3 6 for ambulatory surgical centers under 42 C.F.R. pt. 416. 3 7 2. The department shall adopt rules to govern the notice 3 8 and hearing procedure when a license is denied, suspended, or 3 9 revoked. 3 10 3. The rules shall require ambulatory surgical centers 3 11 to report ambulatory data to the department of public health 3 12 or the designated intermediary for the purpose of public 3 13 dissemination of health data as initially authorized in 1996 3 14 Iowa Acts, chapter 1212, section 5, subsection 1, paragraph "a", 3 15 subparagraph (4). 3 16 4. An ambulatory surgical center which is in operation at 3 17 the time of promulgation of any applicable rules or minimum 3 18 standards under this chapter shall be given a reasonable time, 3 19 not to exceed one year from the date of promulgation, within 3 20 which to comply with such rules and minimum standards. 3 21 5. The department shall enforce the rules. 3 22 Sec. 9. NEW SECTION. 135P.8 Inspections. 3 23 1. The department shall make or cause to be made inspections 3 24 or complaint investigations of ambulatory surgical centers as 3 25 the department deems necessary in order to determine compliance 3 26 with this chapter and applicable rules. 3 27 2. A department inspector shall not participate in an 3 28 inspection or complaint investigation of an ambulatory surgical 3 29 center in which the inspector or a member of the inspector's 3 30 immediate family works or has worked within the last two years 3 31 or in which the inspector or the inspector's immediate family 3 32 has a financial ownership interest. For the purposes of this 3 33 section, "immediate family member" means a spouse, natural or 3 34 adoptive parent or grandparent, child, grandchild, sibling, 3 35 stepparent, stepchild, or stepsibling. 4 1 Sec. 10. NEW SECTION. 135P.9 Employee background checks. 4 2 1. An ambulatory surgical center shall comply with child or 4 3 dependent adult abuse information and criminal record checks 4 4 and evaluations as provided in section 135C.33. 4 5 2. An ambulatory surgical center licensed in this state 4 6 may access the single contact repository established by the 4 7 department pursuant to section 135C.33 as necessary for the 4 8 ambulatory surgical center to perform record checks of persons 4 9 employed or being considered for employment by the ambulatory 4 10 surgical center. 4 11 Sec. 11. NEW SECTION. 135P.10 Confidentiality. 4 12 The department's final inspection or investigation findings 4 13 or the final survey findings of an accrediting body, authorized 4 14 by the department in rule, with respect to compliance by an 4 15 ambulatory surgical center with requirements for licensing 4 16 or accreditation shall be made available to the public in a 4 17 readily available form and place. Other information relating 4 18 to an ambulatory surgical center obtained by the department 4 19 which does not constitute the department's findings from an 4 20 inspection or investigation of the ambulatory surgical center 4 21 or the final survey findings of the accrediting body shall 4 22 not be made available to the public, except in proceedings 4 23 involving the denial, suspension, or revocation of a license 4 24 under this chapter. The name of a person who files a complaint 4 25 with the department shall remain confidential and shall not 4 26 be subject to discovery, subpoena, or other means of legal 4 27 compulsion for its release to a person other than department 4 28 employees or agents involved in the investigation of the 4 29 complaint. 4 30 Sec. 12. NEW SECTION. 135P.11 Judicial review. 4 31 Judicial review of an action of the department may be sought 4 32 in accordance with chapter 17A. Notwithstanding the provisions 4 33 of chapter 17A, petitions for judicial review may be filed 4 34 in the district court of the county in which the ambulatory 4 35 surgical center is located or to be located and the status quo 5 1 of the petitioner or licensee shall be preserved pending final 5 2 disposition of the judicial review matter. 5 3 Sec. 13. NEW SECTION. 135P.12 Penalty. 5 4 Any person establishing, conducting, managing, or operating 5 5 any ambulatory surgical center without a license commits a 5 6 serious misdemeanor, and each day of continuing violation after 5 7 conviction shall be considered a separate offense. 5 8 Sec. 14. NEW SECTION. 135P.13 Injunction. 5 9 Notwithstanding the existence or pursuit of any other 5 10 remedy, the department may, in the manner provided by law, 5 11 maintain an action in the name of the state for injunction 5 12 or other process against any person or governmental unit to 5 13 restrain or prevent the establishment, conduct, management, or 5 14 operation of an ambulatory surgical center without a license. 5 15 Sec. 15. EFFECTIVE DATE. This Act takes effect July 1, 5 16 2013. 5 17 EXPLANATION 5 18 This bill relates to ambulatory surgical centers. The bill 5 19 defines "ambulatory surgical center" using the definition 5 20 provided by Medicare. The bill states the purpose of new Code 5 21 chapter 135P is to protect public health, safety, and welfare 5 22 by providing basic standards for operating, constructing, and 5 23 maintaining an ambulatory surgical center. 5 24 The bill requires that any person or governmental unit 5 25 acting separately or together that establishes, conducts, or 5 26 maintains an ambulatory surgical center must have a license as 5 27 provided under the Code chapter. The person or governmental 5 28 unit shall obtain a license from the department of inspections 5 29 and appeals (DIA). The application shall include information 5 30 that the DIA may reasonably require including affirmative 5 31 evidence of compliance with new Code chapter 135P, other 5 32 statutes, and rules. An application must be accompanied by the 5 33 required initial license fee of $500. An annual license fee is 5 34 also $500. The license fees are to be credited to the state's 5 35 general fund. The bill also provides that the DIA shall issue 6 1 a license upon receiving an application if the applicant 6 2 and the ambulatory surgical center comply with Code chapter 6 3 135P and the rules of the department. A licensee receives 6 4 reapproval upon payment of the $500 license fee and filing 6 5 an application form available from the DIA. Licenses are 6 6 general or restricted in form. A license will be issued only 6 7 for a premises and persons or governmental units named in the 6 8 application and the license is not transferable or assignable 6 9 without written approval of the DIA. The bill requires that 6 10 a license be posted in a conspicuous place on the licensed 6 11 premises as prescribed by department rules. 6 12 The bill states that the DIA may deny, suspend, or revoke a 6 13 license when it finds the licensee or applicant substantially 6 14 failed to comply with Code chapter 135P or rules or minimum 6 15 standards adopted pursuant to the Code chapter. The bill 6 16 states that the DIA rules will govern the procedure for notice 6 17 and hearing to deny an application for a license or to revoke 6 18 or suspend a license. The bill states a full and complete 6 19 record of the proceedings shall be kept, but the record does 6 20 not need to be transcribed unless judicial review is sought. A 6 21 transcript of the proceeding may be obtained by an interested 6 22 party on payment of the cost of preparing the copy or copies. 6 23 The bill provides that the DIA shall adopt rules setting 6 24 the standards for an ambulatory surgical center to be licensed 6 25 under the Code chapter. The rules must require that an 6 26 ambulatory surgical center shall meet the federal requirements 6 27 for conditions of participation in the federal Medicare 6 28 program for ambulatory surgical centers under 42 C.F.R. 6 29 pt. 416. The DIA must also establish, by rule, the notice 6 30 and hearing procedure if a license is denied, revoked, or 6 31 suspended. The DIA must also enforce the rules. The rules 6 32 established by the DIA shall require ambulatory surgical 6 33 centers to report ambulatory data to the department of public 6 34 health or the designated intermediary for purposes of public 6 35 health dissemination of health data. The bill states that 7 1 an ambulatory surgical center in operation at the time of 7 2 promulgation of applicable rules or standards under Code 7 3 chapter 135P shall be given a reasonable time, not to exceed 7 4 one year, to comply with the rules and minimum standards. 7 5 The bill provides for inspections of ambulatory surgical 7 6 centers. The bill requires the DIA to make, or cause to be 7 7 made, inspections or complaint investigations as the DIA deems 7 8 necessary to determine compliance with Code chapter 135P and 7 9 the applicable rules. The DIA inspectors must not participate 7 10 in an inspection or complaint investigation of an ambulatory 7 11 surgical center if the inspector or a member of the inspector's 7 12 immediate family works or has worked at the ambulatory surgical 7 13 center within the last two years. A DIA inspector also must 7 14 not participate in an inspection or complaint investigation 7 15 of an ambulatory surgical center in which the inspector or 7 16 the inspector's immediate family has a financial or ownership 7 17 interest. 7 18 The bill provides that an ambulatory surgical center shall 7 19 comply with abuse and criminal background checks as provided 7 20 in Code section 135C.33. The bill also states that a licensed 7 21 ambulatory surgical center is allowed to access the single 7 22 contact repository as is necessary to perform record checks of 7 23 employees or potential employees. 7 24 The bill provides for the confidentiality of the DIA records 7 25 of ambulatory surgical centers. The bill states that the DIA's 7 26 final inspection or investigation findings, or survey findings 7 27 of an accredited body authorized by the DIA rules, regarding 7 28 an ambulatory surgical center's compliance with requirements 7 29 for licensing or accreditation must be made available to the 7 30 public in a readily available form and place. The bill states 7 31 that other information acquired by the DIA relating to an 7 32 ambulatory surgical center shall not be made available to the 7 33 public except in proceedings involving denial, suspension, 7 34 or revocation of a license. The bill also provides that the 7 35 name of a person who files a complaint with the DIA shall 8 1 remain confidential regardless of means of legal compulsion 8 2 for its release, other than the release of the name to the DIA 8 3 employees or agents involved in investigating a complaint. 8 4 The bill provides that judicial review may be sought 8 5 pursuant to Code chapter 17A, but petitions for judicial review 8 6 may be filed in the district court of the county in which the 8 7 ambulatory surgical center is located or is to be located, 8 8 notwithstanding the terms of Code chapter 17A. The bill 8 9 provides that the status quo of the petitioner or licensee is 8 10 preserved pending final disposition in court. 8 11 The bill establishes a penalty for any person establishing, 8 12 conducting, managing, or operating an ambulatory surgical 8 13 center without a license. The person is guilty of a serious 8 14 misdemeanor and each day of the continuing violation after a 8 15 conviction is a separate offense. 8 16 The bill provides that the DIA may maintain an action in 8 17 the name of the state for an injunction or other process 8 18 against a person or governmental unit to restrain or prevent 8 19 the establishment, conduct, management, or operation of an 8 20 unlicensed ambulatory surgical center. 8 21 The bill provides that the Act takes effect July 1, 2013. LSB 5348YC (6) 84 ad/nh
Text: HSB520            Text: HSB522