senate Bill S396

2011-2012 Legislative Session

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

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Archive: Last Bill Status - In Committee


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

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Mar 12, 2012 committee discharged and committed to rules
Feb 21, 2012 notice of committee consideration - requested
Jan 04, 2012 referred to health
Jan 05, 2011 referred to health

S396 - Bill Details

See Assembly Version of this Bill:
A7185
Current Committee:
Senate Rules
Law Section:
Public Health Law
Laws Affected:
Amd ยง230-d, Pub Health L
Versions Introduced in 2009-2010 Legislative Session:
S8101, A11642

S396 - Bill Texts

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

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BILL NUMBER:S396

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.

LEGISLATIVE HISTORY:

2010: S.8101/A.11642

FISCAL IMPLICATIONS:

None.

EFFECTIVE DATE:

Immediately.

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

                                   396

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 5, 2011
                               ___________

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.
                                                           LBD00727-01-1

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