|
|
To amend sections 3702.30 and 3702.31 and to enact | 1 |
section 3702.301 of the Revised Code to exempt | 2 |
certain freestanding birthing centers from the | 3 |
requirement that a center obtain a health care | 4 |
facility license from the Director of Health. | 5 |
Section 1. That sections 3702.30 and 3702.31 be amended and | 6 |
section 3702.301 of the Revised Code be enacted to read as | 7 |
follows: | 8 |
Sec. 3702.30. (A) As used in this section: | 9 |
(1) "Ambulatory surgical facility" means a facility, whether | 10 |
or not part of the same organization as a hospital, that is | 11 |
located in a building distinct from another in which inpatient | 12 |
care is provided, and to which any of the following apply: | 13 |
(a) Outpatient surgery is routinely performed in the | 14 |
facility, and the facility functions separately from a hospital's | 15 |
inpatient surgical service and from the offices of private | 16 |
physicians, podiatrists, and dentists. | 17 |
(b) Anesthesia is administered in the facility by an | 18 |
anesthesiologist or certified registered nurse anesthetist, and | 19 |
the facility functions separately from a hospital's inpatient | 20 |
surgical service and from the offices of private physicians, | 21 |
podiatrists, and dentists. | 22 |
(c) The facility applies to be certified by the United States | 23 |
24 | |
medicaid services as an ambulatory surgical center for purposes of | 25 |
reimbursement under Part B of the medicare program, Part B of | 26 |
Title XVIII
of the "Social Security
Act," | 27 |
( | 28 |
(d) The facility applies to be certified by a national | 29 |
accrediting body approved by the | 30 |
31 | |
purposes of deemed compliance with the conditions for | 32 |
participating in the medicare program as an ambulatory surgical | 33 |
center. | 34 |
(e) The facility bills or receives from any third-party | 35 |
payer, governmental health care program, or other person or | 36 |
government entity any ambulatory surgical facility fee that is | 37 |
billed or paid in addition to any fee for professional services. | 38 |
(f) The facility is held out to any person or government | 39 |
entity as an ambulatory surgical facility or similar facility by | 40 |
means of signage, advertising, or other promotional efforts. | 41 |
"Ambulatory surgical facility" does not include a hospital | 42 |
emergency department. | 43 |
(2) "Ambulatory surgical facility fee" means a fee for | 44 |
certain overhead costs associated with providing surgical services | 45 |
in an outpatient setting. A fee is an ambulatory surgical facility | 46 |
fee only if it directly or indirectly pays for costs associated | 47 |
with any of the following: | 48 |
(a) Use of operating and recovery rooms, preparation areas, | 49 |
and waiting rooms and lounges for patients and relatives; | 50 |
(b) Administrative functions, record keeping, housekeeping, | 51 |
utilities, and rent; | 52 |
(c) Services provided by nurses, orderlies, technical | 53 |
personnel, and others involved in patient care related to | 54 |
providing surgery. | 55 |
"Ambulatory surgical facility fee" does not include any | 56 |
additional payment in excess of a professional fee that is | 57 |
provided to encourage physicians, podiatrists, and dentists to | 58 |
perform certain surgical procedures in their office or their group | 59 |
practice's office rather than a health care facility, if the | 60 |
purpose of the additional fee is to compensate for additional cost | 61 |
incurred in performing office-based surgery. | 62 |
(3) "Governmental health care program" has the same meaning | 63 |
as in section 4731.65 of the Revised Code. | 64 |
(4) "Health care facility" means any of the following: | 65 |
(a) An ambulatory surgical facility; | 66 |
(b) A freestanding dialysis center; | 67 |
(c) A freestanding inpatient rehabilitation facility; | 68 |
(d) A freestanding birthing center; | 69 |
(e) A freestanding radiation therapy center; | 70 |
(f) A freestanding or mobile diagnostic imaging center. | 71 |
(5) "Third-party payer" has the same meaning as in section | 72 |
3901.38 of the Revised Code. | 73 |
(B) By rule adopted in accordance with sections 3702.12 and | 74 |
3702.13 of the Revised Code, the director of health shall | 75 |
establish quality standards for health care facilities. The | 76 |
standards may incorporate accreditation standards or other quality | 77 |
standards established by any entity recognized by the director. | 78 |
(C) Every ambulatory surgical facility shall require that | 79 |
each physician who practices at the facility comply with all | 80 |
relevant provisions in the Revised Code that relate to the | 81 |
obtaining of informed consent from a patient. | 82 |
(D) The director shall issue a license to each health care | 83 |
facility that makes application for a license and demonstrates to | 84 |
the director that it meets the quality standards established by | 85 |
the rules adopted under division (B) of this section and satisfies | 86 |
the informed consent compliance requirements specified in division | 87 |
(C) of this section. | 88 |
(E)(1) | 89 |
Revised Code, no health care facility shall operate without a | 90 |
license issued under this section. | 91 |
(2) If the department of health finds that a physician who | 92 |
practices at a health care facility is not complying with any | 93 |
provision of the Revised Code related to the obtaining of informed | 94 |
consent from a patient, the department shall report its finding to | 95 |
the state medical board, the physician, and the health care | 96 |
facility. | 97 |
(3) This division does not create, and shall not be construed | 98 |
as creating, a new cause of action or substantive legal right | 99 |
against a health care facility and in favor of a patient who | 100 |
allegedly sustains harm as a result of the failure of the | 101 |
patient's physician to obtain informed consent from the patient | 102 |
prior to performing a procedure on or otherwise caring for the | 103 |
patient in the health care facility. | 104 |
(F) The rules adopted under division (B) of this section | 105 |
shall include all of the following: | 106 |
(1) Provisions governing application for, renewal, | 107 |
suspension, and revocation of a license under this section; | 108 |
(2) Provisions governing orders issued pursuant to section | 109 |
3702.32 of the Revised Code for a health care facility to cease | 110 |
its operations or to prohibit certain types of services provided | 111 |
by a health care facility; | 112 |
(3) Provisions governing the imposition under section 3702.32 | 113 |
of the Revised Code of civil penalties for violations of this | 114 |
section or the rules adopted under this section, including a scale | 115 |
for determining the amount of the penalties. | 116 |
Sec. 3702.301. (A) Except as provided in division (C) of | 117 |
this section, a freestanding birthing center is not required to | 118 |
obtain a license under section 3702.30 of the Revised Code if all | 119 |
of the following are the case: | 120 |
(1) A religious denomination, sect, or group owns and | 121 |
operates the center. | 122 |
(2) Requiring that the center be licensed significantly | 123 |
abridges or infringes on the religious practices or beliefs of | 124 |
that religious denomination, sect, or group. | 125 |
(3) The center provides care only during low-risk pregnancy, | 126 |
delivery, and the immediate postpartum period exclusively to women | 127 |
who are members of that religious denomination, sect, or group. | 128 |
(4) The center monitors and evaluates the care provided to | 129 |
its patients in accordance with at least the minimum patient | 130 |
safety monitoring and evaluation requirements established in rules | 131 |
adopted under division (D) of this section. | 132 |
(5) The center meets the quality assessment and improvement | 133 |
standards established in rules adopted under division (D) of this | 134 |
section. | 135 |
(B) If the director determines that a freestanding birthing | 136 |
center is no longer exempt from the requirement to obtain a | 137 |
license under section 3702.30 of the Revised Code because the | 138 |
center ceases to comply with division (A)(4) or (5) of this | 139 |
section, the director may order the center to come into | 140 |
compliance. In the order, the director may do all of the | 141 |
following: | 142 |
(1) Identify what the center is not in compliance with and | 143 |
what the center needs to do to come into compliance; | 144 |
(2) Require that the center come into compliance within a | 145 |
period of time specified in the order; | 146 |
(3) Require that the center provide the director a written | 147 |
notice within a period of time specified in the order that | 148 |
contains all of the following: | 149 |
(a) Certification that the center has come into compliance; | 150 |
(b) The signature of the center's administrator or medical | 151 |
director and certification that the administrator or medical | 152 |
director, whichever signs the notice, is the center's authorized | 153 |
representative; | 154 |
(c) Certification that the information contained in the | 155 |
notice and any accompanying documentation are true and accurate; | 156 |
(d) Any other information or documentation that the director | 157 |
may require to verify that the center has come into compliance. | 158 |
(C) If the director issues an order to a freestanding | 159 |
birthing center under division (B) of this section and the center | 160 |
fails to comply with the order within the time specified in the | 161 |
order, the director may issue a second order that requires the | 162 |
center to cease operations until the center obtains a license | 163 |
under section 3702.30 of the Revised Code. | 164 |
(D) The director of health shall adopt rules in accordance | 165 |
with Chapter 119. of the Revised Code as necessary to implement | 166 |
this section. The rules shall establish all of the following: | 167 |
(1) Minimum patient safety monitoring and evaluation | 168 |
requirements; | 169 |
(2) Quality assessment and improvement standards; | 170 |
(3) Procedures for determining whether freestanding birthing | 171 |
centers are in compliance with the rules. | 172 |
Sec. 3702.31. (A) The quality monitoring and inspection fund | 173 |
is hereby created in the state treasury. The director of health | 174 |
shall use the fund to administer and enforce this section and | 175 |
sections 3702.11 to 3702.20, 3702.30, 3702.301, and 3702.32 of the | 176 |
Revised Code and rules adopted pursuant to those sections. The | 177 |
director shall deposit in the fund any moneys collected pursuant | 178 |
to this section or section 3702.32 of the Revised Code. All | 179 |
investment earnings of the fund shall be credited to the fund. | 180 |
(B) The director of health shall adopt rules pursuant to | 181 |
Chapter 119. of the Revised Code establishing fees for both of the | 182 |
following: | 183 |
(1) Initial and renewal license applications submitted under | 184 |
section 3702.30 of the Revised Code. The fees established under | 185 |
division (B)(1) of this section shall not exceed the actual and | 186 |
necessary costs of performing the activities described in division | 187 |
(A) of this section. | 188 |
(2) Inspections conducted under section 3702.15 or 3702.30 of | 189 |
the Revised Code. The fees established under division (B)(2) of | 190 |
this section shall not exceed the actual and necessary costs | 191 |
incurred during an inspection, including any indirect costs | 192 |
incurred by the department for staff, salary, or other | 193 |
administrative costs. The director of health shall provide to each | 194 |
health care facility or provider inspected pursuant to section | 195 |
3702.15 or 3702.30 of the Revised Code a written statement of the | 196 |
fee. The statement shall itemize and total the costs incurred. | 197 |
Within fifteen days after receiving a statement from the director, | 198 |
the facility or provider shall forward the total amount of the fee | 199 |
to the director. | 200 |
(3) The fees described in divisions (B)(1) and (2) of this | 201 |
section shall meet both of the following requirements: | 202 |
(a) For each service described in section 3702.11 of the | 203 |
Revised Code, the fee shall not exceed one thousand seven hundred | 204 |
fifty dollars annually, except that the total fees charged to a | 205 |
health care provider under this section shall not exceed five | 206 |
thousand dollars annually. | 207 |
(b) The fee shall exclude any costs reimbursable by the | 208 |
United
States | 209 |
medicare and medicaid services as part of the certification | 210 |
process for the medicare program established under Title XVIII of | 211 |
the
"Social
Security
Act," | 212 |
213 | |
Title
XIX of | 214 |
(1965), 42 U.S.C. 1396. | 215 |
(4) The director shall not establish a fee for any service | 216 |
for which a licensure or inspection fee is paid by the health care | 217 |
provider to a state agency for the same or similar licensure or | 218 |
inspection. | 219 |
Section 2. That existing sections 3702.30 and 3702.31 of the | 220 |
Revised Code are hereby repealed. | 221 |