Bills › 89th General Assembly
HSB 606
Where it is now
- Done: IntroducedJanuary 25, 2022
- Done: SubcommitteeJanuary 25, 2022
- Done: House committeeFebruary 9, 2022
- Skipped: Passes the HouseContinued as HF 2388
- Next: Senate committee
- Next: Passes the Senate
- Next: To the Governor
- Next: Signed into law
Became HF 2388 → Its progress continues under the new number. Go to HF 2388 What’s a funnel?
What’s in it
AI summary Iowa would require outpatient surgery centers to get a license from the state to operate. These facilities must follow specific safety rules and undergo regular inspections to ensure they are safe for patients. The law also requires centers to perform background checks on their employees.1
Read the official explanation
This bill creates a new Code chapter to provide for the licensing and regulation of ambulatory surgical centers. _____ The bill defines “ambulatory surgical center” as a distinct facility that operates exclusively for the purpose of providing surgical services to patients not requiring hospitalization and in which the expected duration of services does not exceed hours following an admission. “Ambulatory surgical center” includes a facility that otherwise meets the definition of an ambulatory surgical center whether or not licensed, certified, or accredited as an ambulatory surgical center and which may or may not operate on a partially cash-only or completely cash-only basis. “Ambulatory surgical center” does not include individual or group practice offices of private physicians or podiatrists that do not contain a distinct area used for outpatient surgical treatment on a regular basis, or that only provide surgery routinely provided in a physician’s or podiatrist’s office using local anesthesia or conscious sedation; individual or group practice offices of dentists; or a portion of a licensed hospital designated for outpatient surgical treatment. The bill prohibits the establishment, operation, or maintenance of an ambulatory surgical center in the state without meeting the requirements of the new Code chapter and obtaining a license. The bill provides for the application for licensure, the issuance and renewal of a license, and the denial, suspension, or revocation of a license, and the associated processes, and for the imposition and payment of associated fees. The bill directs the department of inspections and appeals (DIA) to adopt rules with the advice and approval of the state board of health to specify the standards for ambulatory surgical centers. The rules and standards are required to be consistent with the requirements of the Code chapter and the conditions for coverage in the federal Medicare program for ambulatory surgical centers. _____ maintain an ambulatory surgical center. If an ambulatory surgical center is in operation at the time of adoption of any applicable rules or standards, the center is to be given a reasonable time, not to exceed one year from the date of adoption, within which to comply with such rules and standards. The bill provides for inspections or investigations of ambulatory surgical centers, and directs that the DIA shall perform inspections on a schedule that is of the same frequency required for inspections of Medicare-certified ambulatory surgical centers. The bill also requires the DIA to recognize, in lieu of its own licensure inspection, the comparable inspection and inspection findings of a Medicare conditions for coverage survey completed by the department or a national accreditation agency authorized by the centers for Medicare and Medicaid services of the United States department of health and human services. The bill prohibits a DIA inspector from participating in an inspection or investigation of an ambulatory surgical center in which the inspector or a member of the inspector’s immediate family works or has worked within the last two years or in which the inspector or the inspector’s immediate family has a financial ownership interest.33 (employees and certified nurse aide trainees —— child or dependent adult abuse information and criminal record checks —— evaluations —— application to other providers —— penalty). The bill provides confidentiality provisions relating to ambulatory surgical center information. _____ with respect to compliance by an ambulatory surgical center are to be made available to the public in a readily available form and place. Other information relating to an ambulatory surgical center shall not be made available to the public, except in proceedings involving the denial, suspension, or revocation of a license. The name of a person who files a complaint with the DIA is required to remain confidential and not be subject to discovery, subpoena, or other means of legal compulsion. The bill provides for injunctive relief and judicial review. The bill provides that any person establishing, operating, or maintaining an ambulatory surgical center without a license commits a serious misdemeanor, and each day of continuing violation after conviction shall be considered a separate offense. A serious misdemeanor is punishable by confinement for no more than one year and a fine of at least $430 but not more than $2,560.
House subcommittee
Named January 25, 2022. On February 1, 2022 it recommended passage. Vote Total: 3-0.
Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part
Fiscal note
AI summary This bill creates a new system for licensing and regulating ambulatory surgical centers through the Department of Inspections and Appeals. While the bill would bring in $14,000 in annual renewal revenue from current Medicare-certified providers and $500 annually for each non-Medicare-certified center, the overall fiscal impact on the Department of Inspections and Appeals cannot be determined because the number of non-Medicare-certified centers is unknown. Additionally, the fiscal impact on the correctional system cannot be determined because the bill establishes a new criminal offense.3
Read the fiscal note
Description
House File 2584 creates a new Iowa Code chapter to provide for the licensing and regulation of ambulatory surgical centers and designates the Department of Inspections and Appeals (DIA) to administer the chapter. The fee for an application for initial license of an ambulatory surgical center is $50, and the fee for an annual license renewal is $500. License fees will be considered repayment receipts and will be used by the DIA for administration. The Bill provides authority to the DIA to deny, suspend, or revoke licenses. The DIA is directed to adopt rules relating to the standards, issuance, renewal, denial, suspension, and revocation of a license to establish, operate, and maintain an ambulatory surgical center.
The Bill requires the DIA to perform inspections of ambulatory surgical centers on a schedule that is of the same frequency required for inspections of Medicare-certified ambulatory surgical centers and to recognize, in lieu of its own inspection, the comparable inspection or inspection findings of a Medicare conditions for coverage survey completed by the DIA or an accrediting organization authorized by the Centers for Medicare and Medicaid Services. Additionally, the Bill requires the Department of Public Safety to perform a criminal history check and the Department of Human Services must perform child and dependent adult abuse record checks prior to employment of a person in an ambulatory surgical center.
Final findings of an ambulatory surgical center’s compliance must be made available to the public. The Bill provides for injunctive relief and judicial review. The Department of Public Health is also directed to adopt rules requiring ambulatory surgical centers to report data that is consistent with the data required to be reported to the Centers for Medicare and Medicaid Services.
Any person establishing, operating, or maintaining any ambulatory surgical center without a license commits a serious misdemeanor under the Bill. Each day of continuing violation after conviction is considered a separate offense. Additionally, any person required to inform an ambulatory surgical center of a conviction or entry of an abuse record and who fails to do so within the required period commits a serious misdemeanor.
Background
A serious misdemeanor is punishable by confinement for no more than one year and fine of at least $430 but not more than $2,560.
Assumptions
- The following will not change over the projection period: charge, conviction, and sentencing patterns and trends, prisoner length of stay (LOS), revocation rates, plea bargaining, and other criminal justice system policies and practices.
- A lag effect of six months is assumed from the effective date of this Bill to the date of first entry of affected offenders into the correctional system.
- Marginal costs for county jails cannot be estimated due to a lack of data. For purposes of this analysis, the marginal cost for county jails is assumed to be $50 per day.
- The fee for an initial license of an ambulatory surgical center is to be sufficient to cover the costs of performing the inspection. The fee for an annual license renewal is $500.
- The costs for performing an initial inspection and renewal activity for one facility include preparation, travel, on-site, and write-up time for the surveyors; inspection review and approval time by the program coordinator; and time for support in issuing the inspection results. These costs will be incurred for one new non-Medicare-certified ambulatory surgical center.
- There are currently 28 Medicare-certified providers in the State.
- The number of non-Medicare-certified ambulatory surgical centers in the State is unknown.
Correctional Impact
The correctional impact of HF 2584 cannot be determined. The Bill establishes a new Iowa Code chapter, and a correctional impact cannot be assessed. Table 1 shows estimates for sentencing to State prison, parole, probation, or Community-Based Corrections (CBC) residential facilities; LOS under those supervisions; and supervision marginal costs per day for all convictions of serious misdemeanors. Refer to the Legislative Services Agency (LSA) memo addressed to the General Assembly, Cost Estimates Used for Correctional Impact Statements, dated January 18, 2022, for information related to the correctional system. Table 1 — Sentencing Estimates and LOS
Minority Impact
House File 2584 establishes a new Iowa Code chapter, and a minority impact cannot be estimated. Refer to the LSA memo addressed to the General Assembly, Minority Impact Statement, dated January 18, 2022, for information related to minorities in the criminal justice system.
Fiscal Impact
The fiscal impact of House File 2584 to the correctional system cannot be determined, as the Bill establishes a new criminal offense, and the resulting cost to the justice system cannot be determined. The average State cost per offense for a serious misdemeanor ranges from $410 to $7,000. The cost estimates include operating costs incurred by the Judicial Branch, the State Public Defender, and the Department of Corrections for one conviction. The cost would be incurred across multiple fiscal years for prison and parole supervision. For current Medicare-certified providers, there will be $14,000 in annual renewal revenue. For each non-Medicare-certified ambulatory surgical center, there will be an additional $500 in renewal revenue annually. The cost for performing an initial inspection and renewal activity for one non-Medicare-certified ambulatory surgical center is approximately $4,600. Therefore, total annual revenue will cover renewal costs if there are up to three non-Medicare-certified ambulatory surgical centers. However, due to the unknown number of non-Medicare-certified centers in the State, the overall fiscal impact to the DIA of licensing fees and regulation of ambulatory surgical centers cannot be determined at this time.Conviction
Offense Class
Percent
Ordered to
State Prison
FY 21 Avg
LOS in Prison
(All Releases) FY 21
Marginal
Cost Per
Day Prison
Percent
Ordered to
Probation
Avg LOS
on
Probation
FY 21 Avg
Cost Per Day
on Probation
Percent
Sentenced to
CBC Residential
Facility
FY 21
Marginal
Cost CBC
Per Day
Percent
Ordered to
County Jail
Marginal
Cost Per
Day Jail
Avg LOS
on Parole FY 21
Marginal
Cost Per
Day Parole
Serious
Misdemeanor 1.8% 6.5 $23.33 56.0% 14.5 $7.01 0.9% $17.78 69.0% $50.00 18.1 $7.01
Sources
- Criminal and Juvenile Justice Planning Division, Department of Human Rights
- Department of Inspections and Appeals
- Department of Public Safety
- Department of Public Health
- Department of Human Services
- Ambulatory Surgical Center, Certification or Accreditation · April 11, 2022 · $7,000
Iowa Code it changes
Creates§135Q.1§135Q.10§135Q.11§135Q.2§135Q.3§135Q.4§135Q.5§135Q.6§135Q.7§135Q.8§135Q.9
Lobbying
0 for · 2 against · 16 undecided · Who →
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Tried before
Study bill
89th General Assembly
Earlier and later bills are matched by wording or an identical title.
Tried before
This idea has been filed in an earlier General Assembly. None got through a chamber.
- HF 2401 Relating to the licensure of ambulatory surgical centers, providing for fees to be conside…88th General Assembly · In committee · nearly identicalCleared committee
Similar bills this General Assembly
- HF 117 Relating to the licensure of ambulatory surgical centers, providing for fees to be conside…89th General Assembly · In committeeNearly identical
Matched by wording or an identical title.