senate Bill S3154

Relates to payment for services performed in an office-based surgical facility

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
view actions

actions

  • 30 / Jan / 2013
    • REFERRED TO HEALTH
  • 08 / Jan / 2014
    • REFERRED TO HEALTH

Summary

Relates to payment for services performed in an office-based surgical facility.

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Bill Details

See Assembly Version of this Bill:
A2553
Versions:
S3154
Legislative Cycle:
2013-2014
Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Amd ยง230-d, Pub Health L
Versions Introduced in Previous Legislative Cycles:
2011-2012: S396, A7185
2009-2010: S8101, A11642

Sponsor Memo

BILL NUMBER:S3154

TITLE OF BILL: An act to amend the public health law, in relation to
payment for services performed in an office-based surgical facility

PURPOSE: To require health plans to provide payment to a physician
for the use of the office-based surgical facility in the performance
of medically necessary procedures performed in accredited office-based
practices.

SUMMARY OF PROVISIONS: This bill amends Section 230-d of the public
health law to require a health plan to provide reimbursement to
physician for the use of the office-based surgical facility in
addition to the fee charged for the performance of a medically
necessary procedure involving a health plan enrollee or insured,
provided that such office-based surgical facility has achieved
accredited status as required by Section 230-d(2).

EXISTING LAW: Current law requires physicians in whose practice
office-based surgery is performed to obtain and maintain full
accredited status by a nationally-recognized accredited agency
approved by the Commissioner of Health. There are three accreditation
entities which have been approved by the Commissioner: Accreditation
Association for Ambulatory Health Care (AAAHC), American Association
for Accreditation of Ambulatory Surgery Facilities (AAAASF) and The
Joint Commission.

JUSTIFICATION: In 2007, legislation to require physicians who perform
office-based surgery in their offices to obtain accreditation of such
office setting was passed by both Houses of the Legislature. This
measure was the culmination of the work of the Department of Health's
Committee on Quality Assurance in Office-Based Surgery. The Committee
concluded that "the New York State Department of Health should seek
the legislative authority to require accreditation of office-based
surgical practices, including adverse event reporting" as outlined in
their report. The resulting legislation defined OBS as "any surgical
or other invasive procedure (excluding minimal procedures and
procedures requiring minimal sedation) requiring moderate or deep
sedation or general anesthesia and unsupplemented liposuction of
greater than 500cc." Exempt from the accreditation requirements of the
bill are practices that are limited to minor procedures (performed
with local or topical anesthesia or liposuction with removal of less
than 500 cc of fat under unsupplemented local anesthesia) or
procedures performed using minimal sedation ("means a drug induced
state during which (i) patients respond normally to verbal commands;
(ii) cognitive function and coordination may be impaired and (iii)
ventilatory and cardiovascular functions are unaffected"). The
accreditation conferred upon these office-based surgical practices
assures that these practices meet nationally recognized standard which
address the office-based surgery practices include: environment of
care; emergency management; infection prevention and control; life
safety; medication management; national patient safety goals;
performance improvement; record of care, treatment of services; rights
and responsibilities of the individual; and transplant safety. OBS
practices provide a higher quality of care at a lower cost than care
provided in more costly ambulatory surgery centers and hospital out


patient departments. Several health plans, however, fail to pay
physicians with accredited office based surgical practices a facility
fee. Payment of a facility fee in addition to the fee charged for the
performance of a medically necessary procedure will assure the
continued operation of these cost-efficient OBS practices.

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: Immediately.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  3154

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 30, 2013
                               ___________

Introduced  by  Sen. KRUEGER -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public  health  law,  in  relation  to  payment  for
  services performed in an office-based surgical facility

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Section 230-d of the public health law is amended by adding
a new subdivision 6 to read as follows:
  6. ANY LICENSEE WHO OBTAINS ACCREDITED STATUS AS SET FORTH PURSUANT TO
THIS SECTION SHALL RECEIVE PAYMENT FROM A HEALTH PLAN FOR THE USE OF THE
OFFICE-BASED SURGICAL FACILITY IN ADDITION TO THE FEE  CHARGED  FOR  THE
PERFORMANCE OF THE MEDICALLY NECESSARY PROCEDURE INVOLVING A HEALTH PLAN
ENROLLEE  OR  INSURED.  FOR  THE PURPOSES OF THIS SECTION, "HEALTH PLAN"
SHALL BE DEFINED AS AN INSURER THAT IS LICENSED UNDER THE INSURANCE  LAW
TO  WRITE ACCIDENT AND HEALTH INSURANCE, OR THAT IS LICENSED PURSUANT TO
ARTICLE FORTY-THREE OF THE INSURANCE LAW, OR IS  CERTIFIED  PURSUANT  TO
ARTICLE FORTY-FOUR OF THIS CHAPTER.
  S 2. This act shall take effect immediately.





 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06296-01-3

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