Connecticut Seal

General Assembly

 

Raised Bill No. 647

February Session, 2006

 

LCO No. 3026

 

*03026_______PH_*

Referred to Committee on Public Health

 

Introduced by:

 

(PH)

 

AN ACT CONCERNING SURGICAL SERVICES.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Section 19a-493b of the 2006 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2006):

(a) As used in this section and subsection (a) of section 19a-490, as amended, "outpatient surgical facility" means any entity, individual, firm, partnership, corporation, limited liability company or association, other than a hospital, engaged in providing surgical services or diagnostic procedures for human health conditions that include the use of moderate or deep sedation, moderate or deep analgesia or general anesthesia, as such levels of anesthesia are defined from time to time by the American Society of Anesthesiologists, or by such other professional or accrediting entity recognized by the Department of Public Health. [An outpatient surgical facility shall not include a medical office owned and operated exclusively by a person or persons licensed pursuant to section 20-13, provided such medical office] An outpatient surgical facility does not include a medical office owned and operated exclusively by a person or persons licensed pursuant to section 20-13 who has applied to the Office of Health Care Access for an exemption from this section, and received a determination by the Office of Health Care Access that the medical office: (1) Has no operating room or designated surgical area; (2) bills no facility fees to third party payers; (3) administers no deep sedation or general anesthesia; (4) performs only minor surgical procedures incidental to the work performed in said medical office of the physician or physicians that own and operate such medical office; and (5) uses only light or moderate sedation or analgesia in connection with such incidental minor surgical procedures. Nothing in this subsection shall be construed to affect any obligation to comply with the provisions of section 19a-691.

(b) No entity, individual, firm, partnership, corporation, limited liability company or association, other than a hospital, shall individually or jointly establish or operate an outpatient surgical facility in this state without complying with chapter 368z, except as otherwise provided by this section, and obtaining a license within the time specified in this subsection from the Department of Public Health for such facility pursuant to the provisions of this chapter, unless such entity, individual, firm, partnership, corporation, limited liability company or association: (1) Provides to the Office of Health Care Access satisfactory evidence that it was in operation on or before July 1, 2003, or (2) obtained, on or before July 1, 2003, from the Office of Health Care Access, a determination that a certificate of need is not required. An entity, individual, firm, partnership, corporation, limited liability company or association otherwise in compliance with this section may operate an outpatient surgical facility without a license through March 30, 2007, and shall have until March 30, 2007, to obtain a license from the Department of Public Health.

(c) Notwithstanding the provisions of this section, no outpatient surgical facility shall be required to comply with section 19a-631, 19a-632, 19a-637a, 19a-644, 19a-645, as amended, 19a-646, 19a-648, 19a-649, 19a-650, 19a-652, or 19a-654 to 19a-683, inclusive. Each outpatient surgical facility shall continue to be subject to the obligations and requirements applicable to such facility, including, but not limited to, any applicable provision of this chapter and those provisions of chapter 368z not specified in this subsection, except that a request for permission to undertake a transfer or change of ownership or control shall not be required pursuant to subsection (a) of section 19a-638, as amended, if the Office of Health Care Access determines that the following conditions are satisfied: (1) Prior to any such transfer or change of ownership or control, the outpatient surgical facility shall be owned and controlled exclusively by persons licensed pursuant to section 20-13, either directly or through a limited liability company, formed pursuant to chapter 613, a corporation, formed pursuant to chapters 601 and 602, or a limited liability partnership, formed pursuant to chapter 614, that is exclusively owned by persons licensed pursuant to section 20-13, or is under the interim control of an estate executor or conservator pending transfer of an ownership interest or control to a person licensed under section 20-13, and (2) after any such transfer or change of ownership or control, persons licensed pursuant to section 20-13, a limited liability company, formed pursuant to chapter 613, a corporation, formed pursuant to chapters 601 and 602, or a limited liability partnership, formed pursuant to chapter 614, that is exclusively owned by persons licensed pursuant to section 20-13, shall own and control no less than a [sixty] one hundred per cent interest in the outpatient surgical facility.

(d) The provisions of this section shall not apply to persons licensed to practice dentistry or dental medicine pursuant to chapter 379 or to outpatient clinics licensed pursuant to this chapter.

(e) Any outpatient surgical facility that is accredited as provided in section 19a-691 shall continue to be subject to the requirements of section 19a-691.

(f) [The] (1) From the effective date of this section until March 1, 2007, the Commissioner of Public Health may provide a waiver for outpatient surgical facilities from the physical plant and staffing requirements of the licensing regulations adopted pursuant to this chapter, provided no waiver may be granted unless the health, safety and welfare of patients is ensured.

(2) Not later than March 1, 2007, the Commissioner of Public Health shall adopt regulations, in accordance with chapter 54, to require minimum standards for physical plant to protect the health, safety and welfare of patients. Such regulations shall contain levels of physical plant requirements based on criteria determined by the Department of Public Health, including the volume of surgeries and procedures, the types of surgeries and procedures and the best interests of patients.

(g) Each outpatient surgical facility shall provide the following data to the Office of Health Care Access: (1) The number of procedures performed annually, (2) the types of procedures, (3) the number of operating rooms, (4) the number of full-time employee equivalents, (5) the names of licensed professionals performing services at the facility, (6) the composition of payers for procedures performed at the facility, and (7) such other information as the Office of Health Care Access deems necessary.

(h) The Office of Health Care Access shall compare the data submitted to the office pursuant to subsection (g) of this section to determine whether each outpatient surgical facility submitting such data is in compliance with its certificate of need. The Office of Health Care Access shall take such actions as it deems appropriate if it determines that an outpatient surgical facility's data is at variance with the facility's certificate of need.

This act shall take effect as follows and shall amend the following sections:

Section 1

October 1, 2006

19a-493b

Statement of Purpose:

To clarify the scope of oversight by the Office of Health Care Access relative to outpatient surgical facilities.

[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]