BILL NO A06702
SAME AS No same as
Amd S230-d, Pub Health L
Requires all facilities operated as an office-based practice or setting to
annually register with its accrediting agency, in consultation with the
department of health; makes such facilities eligible for payments from health
insurers for use of an accredited office-based surgery facility, in addition to
payments to the surgeon for the procedure.
S T A T E O F N E W Y O R K
2013-2014 Regular Sessions
I N A S S E M B L Y
April 16, 2013
Introduced by M. of A. QUART -- read once and referred to the Committee
AN ACT to amend the public health law, in relation to registration of
office-based surgery facilities and payments for the use thereof
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Subdivision 1 of section 230-d of the public health law is
2 amended by adding two new paragraphs (j) and (k) to read as follows:
3 (J) "LICENSEE PRACTICE" SHALL MEAN AN OFFICE-BASED SURGERY FACILITY,
4 WHICH HAS ACCREDITED STATUS. SUCH A FACILITY MAY OPERATE UNDER THE
5 LICENSE OF THE LICENSEE.
6 (K) "HEALTH PLAN" SHALL MEAN AN INSURER LICENSED PURSUANT TO THE
7 INSURANCE LAW TO WRITE ACCIDENT AND HEALTH INSURANCE, OR A NON-PROFIT
8 MEDICAL AND DENTAL INDEMNITY, OR HEALTH AND HOSPITAL SERVICE CORPORATION
9 LICENSED PURSUANT TO ARTICLE FORTY-THREE OF THE INSURANCE LAW, OR A
10 HEALTH MAINTENANCE ORGANIZATION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR
11 OF THIS CHAPTER.
12 S 2. Section 230-d of the public health law is amended by adding two
13 new subdivisions 3-a and 6 to read as follows:
14 3-A. (A) EVERY FACILITY OPERATED AS AN OFFICE-BASED SURGERY PRACTICE
15 OR SETTING SHALL, NOT LATER THAN JANUARY FIRST, TWO THOUSAND FOURTEEN,
16 IN ADDITION TO OBTAINING AND MAINTAINING FULL ACCREDITED STATUS, HOLD A
17 CERTIFICATE OF REGISTRATION ISSUED BY THE ACCREDITING AGENCY, IN CONSUL-
18 TATION WITH THE DEPARTMENT. THE ACCREDITING AGENCY SHALL ISSUE A CERTIF-
19 ICATE TO AN APPLICANT LICENSEE PRACTICE WHICH:
20 (I) FILES AN APPLICATION FOR REGISTRATION IN SUCH FORM AND HAVING SUCH
21 CONTENT AS SHALL BE DETERMINED BY THE ACCREDITING AGENCY, IN CONSULTA-
22 TION WITH THE DEPARTMENT;
23 (II) HAS SUCCESSFULLY COMPLETED AN ON-SITE INSPECTION OF THE FACILITY
24 CONDUCTED BY A NATIONALLY-RECOGNIZED ACCREDITING AGENCY AS DESIGNATED BY
25 THE COMMISSIONER;
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
A. 6702 2
1 (III) SUBMITS PROOF OF ITS FULL ACCREDITED STATUS; AND
2 (IV) THE INITIAL CERTIFICATION OF WHICH HAS AN INITIATION DATE OF THE
3 FIRST DATE OF ACCREDITATION AS LONG AS THE FACILITY REMAINS FULLY
4 ACCREDITED PURSUANT TO THIS SECTION.
5 (B) NO FACILITY OPERATED AS AN OFFICE-BASED SURGERY PRACTICE OR
6 SETTING SHALL HOLD ITSELF OUT AS OR REPRESENT THAT IT IS REGISTERED,
7 UNLESS IT HOLDS A VALID CERTIFICATE OF REGISTRATION ISSUED PURSUANT TO
8 THIS SUBDIVISION.
9 (C) THE CERTIFICATE OF REGISTRATION ISSUED TO A FACILITY PURSUANT TO
10 THIS SUBDIVISION SHALL BE CONSPICUOUSLY POSTED AT THE PRINCIPAL ADMINIS-
11 TRATIVE OFFICE OF SUCH FACILITY.
12 (D) IN THE EVENT THE ACCREDITING AGENCY FINDS THAT AN APPLICATION
13 SUBMITTED PURSUANT TO PARAGRAPH (A) OF THIS SUBDIVISION CONTAINS OR
14 EVINCES ANY DEFICIENCY IN THE APPLICANT'S ACCREDITED STATUS, THE ACCRED-
15 ITING AGENCY MAY ISSUE A PROVISIONAL CERTIFICATE OF REGISTRATION FOR
16 SUCH PERIOD OF TIME AS MAY BE NECESSARY TO CURE SUCH DEFICIENCY. NO SUCH
17 PROVISIONAL CERTIFICATE SHALL BE ISSUED UNTIL THE APPLICANT AGREES IN
18 WRITING TO FULLY COMPLY WITH THE PROVISION OF THIS SECTION.
19 (E) EACH CERTIFICATE OF REGISTRATION SHALL BE VALID FOR A PERIOD OF
20 THREE YEARS, OR UNTIL THE ACCREDITED STATUS OF THE FACILITY EXPIRES,
21 WHICHEVER SHALL OCCUR FIRST.
22 6. EVERY FACILITY OPERATED AS AN OFFICE-BASED SURGERY PRACTICE OR
23 SETTING WITH FULL ACCREDITED STATUS, INCLUDING A CURRENT CERTIFICATE OF
24 REGISTRATION, SHALL BE ELIGIBLE TO SEEK PAYMENT FROM A HEALTH PLAN FOR
25 THE USE OF SUCH FACILITY. SUCH PAYMENT SHALL BE IN ADDITION TO THE FEE
26 CHARGED BY THE LICENSEE FOR THE PERFORMANCE OF THE COVERED OFFICE-BASED
27 SURGERY INVOLVING AN INSURED OR A HEALTH PLAN ENROLLEE; PROVIDED THAT
28 THE HEALTH PLAN ALSO REIMBURSES FOR THE USE OF A FACILITY CHARGED IN
29 CONNECTION WITH THE SAME COVERED PROCEDURE PERFORMED AT A HOSPITAL OR
30 AMBULATORY SURGERY CENTER ORGANIZED PURSUANT TO ARTICLE TWENTY-EIGHT OF
31 THIS CHAPTER. WHEN CALCULATING THE APPROPRIATE RATE OF OFFICE-BASED
32 SURGERY FACILITY FEES, A HEALTH PLAN MAY ALSO TAKE INTO CONSIDERATION
33 CERTAIN COMPARABLE AND NON-COMPARABLE COSTS AND OBLIGATIONS OF AMBULATO-
34 RY SURGERY CENTERS AND HOSPITALS.
35 S 3. This act shall take effect immediately; provided, however, that
36 subdivision 6 of section 230-d of the public health law, as added by
37 section two of this act, shall be deemed to have been in full force and
38 effect on and after January 18, 2009, and shall only apply to facilities
39 during the period of time which they remain fully accredited pursuant to
40 section 230-d of the public health law.