As Reported by the Senate Health, Human Services and Aging Committee

126th General Assembly Regular Session 2005-2006

Sub. H. B. No. 287

Representatives Aslanides, Kearns, Carmichael, Gibbs, Perry, McGregor, J., Dolan, Collier, Hood, Beatty, Reidelbach, Barrett, Boccieri, Brown, Carano, Daniels, DeBose, Domenick, Evans, D., Flowers, Hagan, Hughes, Law, Sayre, Schlichter, Schneider, Stewart, J., Uecker, Wagoner 

Senators Coughlin, Gardner, Jacobson, Clancy 

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A BILL

To amend sections 3702.30 and 3702.31 and to enact

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sections 2305.116 and 3702.301 of the Revised Code

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to exempt certain freestanding birthing centers

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from the requirement that a center obtain a health

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care facility license from the Director of Health

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and to provide that there is no cause of action on

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a medical claim that because of an act or omission

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an abortion was not performed.

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BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 3702.30 and 3702.31 be amended and	9
sections 2305.116 and 3702.301 of the Revised Code be enacted to	10
read as follows:	11

Sec. 2305.116.  (A) No person has a civil action or may	12
receive an award of damages in a civil action, and no other person	13
shall be liable in a civil action, upon a medical claim that	14
because of an act or omission by the other person the person was	15
not aborted.	16

(B) No person has a civil action or may receive an award of	17
damages in a civil action, and no other person shall be liable in	18
a civil action, upon a medical claim that because of an act or	19
omission by the other person a child was not aborted.	20

(C) Nothing in this section shall preclude a person from	21
bringing a civil action or from receiving an award of damages in a	22
medical claim based upon an intentional or willful	23
misrepresentation or omission of information related to medical	24
diagnosis, care, or treatment.	25

(D) As used in this section, "medical claim" has the same	26
meaning as in section 2305.113 of the Revised Code.	27

Sec. 3702.30.  (A) As used in this section:

28

(1) "Ambulatory surgical facility" means a facility, whether	29
or not part of the same organization as a hospital, that is	30
located in a building distinct from another in which inpatient	31
care is provided, and to which any of the following apply:	32

(a) Outpatient surgery is routinely performed in the	33
facility, and the facility functions separately from a hospital's	34
inpatient surgical service and from the offices of private	35
physicians, podiatrists, and dentists.	36

(b) Anesthesia is administered in the facility by an	37
anesthesiologist or certified registered nurse anesthetist, and	38
the facility functions separately from a hospital's inpatient	39
surgical service and from the offices of private physicians,	40
podiatrists, and dentists.	41

(c) The facility applies to be certified by the United States	42
health care financing administrationcenters for medicare and	43
medicaid services as an ambulatory surgical center for purposes of	44
reimbursement under Part B of the medicare program, Part B of	45
Title XVIII of the "Social Security Act," 4979 Stat. 620286	46
(19351965), 42 U.S.C.A. 3011395, as amended.	47

(d) The facility applies to be certified by a national	48
accrediting body approved by the health care financing	49
administrationcenters for medicare and medicaid services for	50
purposes of deemed compliance with the conditions for	51
participating in the medicare program as an ambulatory surgical	52
center.	53

(e) The facility bills or receives from any third-party	54
payer, governmental health care program, or other person or	55
government entity any ambulatory surgical facility fee that is	56
billed or paid in addition to any fee for professional services.	57

(f) The facility is held out to any person or government	58
entity as an ambulatory surgical facility or similar facility by	59
means of signage, advertising, or other promotional efforts.	60

"Ambulatory surgical facility" does not include a hospital	61
emergency department.	62

(2) "Ambulatory surgical facility fee" means a fee for	63
certain overhead costs associated with providing surgical services	64
in an outpatient setting. A fee is an ambulatory surgical facility	65
fee only if it directly or indirectly pays for costs associated	66
with any of the following:	67

(a) Use of operating and recovery rooms, preparation areas,	68
and waiting rooms and lounges for patients and relatives;	69

(b) Administrative functions, record keeping, housekeeping,	70
utilities, and rent;	71

(c) Services provided by nurses, orderlies, technical	72
personnel, and others involved in patient care related to	73
providing surgery.	74

"Ambulatory surgical facility fee" does not include any	75
additional payment in excess of a professional fee that is	76
provided to encourage physicians, podiatrists, and dentists to	77
perform certain surgical procedures in their office or their group	78
practice's office rather than a health care facility, if the	79
purpose of the additional fee is to compensate for additional cost	80
incurred in performing office-based surgery.	81

(3) "Governmental health care program" has the same meaning	82
as in section 4731.65 of the Revised Code.	83

(4) "Health care facility" means any of the following:

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(a) An ambulatory surgical facility;

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(b) A freestanding dialysis center;

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(c) A freestanding inpatient rehabilitation facility;

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(d) A freestanding birthing center;

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(e) A freestanding radiation therapy center;

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(f) A freestanding or mobile diagnostic imaging center.

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(5) "Third-party payer" has the same meaning as in section	91
3901.38 of the Revised Code.	92

(B) By rule adopted in accordance with sections 3702.12 and	93
3702.13 of the Revised Code, the director of health shall	94
establish quality standards for health care facilities. The	95
standards may incorporate accreditation standards or other quality	96
standards established by any entity recognized by the director.	97

(C) Every ambulatory surgical facility shall require that	98
each physician who practices at the facility comply with all	99
relevant provisions in the Revised Code that relate to the	100
obtaining of informed consent from a patient.	101

(D) The director shall issue a license to each health care	102
facility that makes application for a license and demonstrates to	103
the director that it meets the quality standards established by	104
the rules adopted under division (B) of this section and satisfies	105
the informed consent compliance requirements specified in division	106
(C) of this section.	107

(E)(1) NoExcept as provided in section 3702.301 of the	108
Revised Code, no health care facility shall operate without a	109
license issued under this section.	110

(2) If the department of health finds that a physician who	111
practices at a health care facility is not complying with any	112
provision of the Revised Code related to the obtaining of informed	113
consent from a patient, the department shall report its finding to	114
the state medical board, the physician, and the health care	115
facility.	116

(3) This division does not create, and shall not be construed	117
as creating, a new cause of action or substantive legal right	118
against a health care facility and in favor of a patient who	119
allegedly sustains harm as a result of the failure of the	120
patient's physician to obtain informed consent from the patient	121
prior to performing a procedure on or otherwise caring for the	122
patient in the health care facility.	123

(F) The rules adopted under division (B) of this section	124
shall include all of the following:	125

(1) Provisions governing application for, renewal,	126
suspension, and revocation of a license under this section;	127

(2) Provisions governing orders issued pursuant to section	128
3702.32 of the Revised Code for a health care facility to cease	129
its operations or to prohibit certain types of services provided	130
by a health care facility;	131

(3) Provisions governing the imposition under section 3702.32	132
of the Revised Code of civil penalties for violations of this	133
section or the rules adopted under this section, including a scale	134
for determining the amount of the penalties.	135

Sec. 3702.301.  (A) Except as provided in division (C) of	136
this section, a freestanding birthing center is not required to	137
obtain a license under section 3702.30 of the Revised Code if all	138
of the following are the case:	139

(1) A religious denomination, sect, or group owns and	140
operates the center.	141

(2) Requiring that the center be licensed significantly	142
abridges or infringes on the religious practices or beliefs of	143
that religious denomination, sect, or group.	144

(3) The center provides care only during low-risk pregnancy,	145
delivery, and the immediate postpartum period exclusively to women	146
who are members of that religious denomination, sect, or group.	147

(4) The center monitors and evaluates the care provided to	148
its patients in accordance with at least the minimum patient	149
safety monitoring and evaluation requirements established in rules	150
adopted under division (D) of this section.	151

(5) The center meets the quality assessment and improvement	152
standards established in rules adopted under division (D) of this	153
section.	154

(B) If the director determines that a freestanding birthing	155
center is no longer exempt from the requirement to obtain a	156
license under section 3702.30 of the Revised Code because the	157
center ceases to comply with division (A)(4) or (5) of this	158
section, the director may order the center to come into	159
compliance. In the order, the director may do all of the	160
following:	161

(1) Identify what the center is not in compliance with and	162
what the center needs to do to come into compliance;	163

(2) Require that the center come into compliance within a	164
period of time specified in the order;	165

(3) Require that the center provide the director a written	166
notice within a period of time specified in the order that	167
contains all of the following:	168

(a) Certification that the center has come into compliance;

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(b) The signature of the center's administrator or medical	170
director and certification that the administrator or medical	171
director, whichever signs the notice, is the center's authorized	172
representative;	173

(c) Certification that the information contained in the	174
notice and in any accompanying documentation is true and accurate;	175

(d) Any other information or documentation that the director	176
may require to verify that the center has come into compliance.	177

(C) If the director issues an order to a freestanding	178
birthing center under division (B) of this section and the center	179
fails to comply with the order within the time specified in the	180
order, the director may issue a second order that requires the	181
center to cease operations until the center obtains a license	182
under section 3702.30 of the Revised Code.	183

(D) The director of health shall adopt rules in accordance	184
with Chapter 119. of the Revised Code as necessary to implement	185
this section. The rules shall establish all of the following:	186

(1) Minimum patient safety monitoring and evaluation	187
requirements;	188

(2) Quality assessment and improvement standards;

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(3) Procedures for determining whether freestanding birthing	190
centers are in compliance with the rules.	191

Sec. 3702.31.  (A) The quality monitoring and inspection fund	192
is hereby created in the state treasury. The director of health	193
shall use the fund to administer and enforce this section and	194
sections 3702.11 to 3702.20, 3702.30, 3702.301, and 3702.32 of the	195
Revised Code and rules adopted pursuant to those sections. The	196
director shall deposit in the fund any moneys collected pursuant	197
to this section or section 3702.32 of the Revised Code. All	198
investment earnings of the fund shall be credited to the fund.	199

(B) The director of health shall adopt rules pursuant to	200
Chapter 119. of the Revised Code establishing fees for both of the	201
following:	202

(1) Initial and renewal license applications submitted under	203
section 3702.30 of the Revised Code. The fees established under	204
division (B)(1) of this section shall not exceed the actual and	205
necessary costs of performing the activities described in division	206
(A) of this section.	207

(2) Inspections conducted under section 3702.15 or 3702.30 of	208
the Revised Code. The fees established under division (B)(2) of	209
this section shall not exceed the actual and necessary costs	210
incurred during an inspection, including any indirect costs	211
incurred by the department for staff, salary, or other	212
administrative costs. The director of health shall provide to	213
each health care facility or provider inspected pursuant to	214
section 3702.15 or 3702.30 of the Revised Code a written statement	215
of the fee. The statement shall itemize and total the costs	216
incurred. Within fifteen days after receiving a statement from	217
the director, the facility or provider shall forward the total	218
amount of the fee to the director.	219

(3) The fees described in divisions (B)(1) and (2) of this	220
section shall meet both of the following requirements:	221

(a) For each service described in section 3702.11 of the	222
Revised Code, the fee shall not exceed one thousand seven hundred	223
fifty dollars annually, except that the total fees charged to a	224
health care provider under this section shall not exceed five	225
thousand dollars annually.	226

(b) The fee shall exclude any costs reimbursable by the	227
United States health care financing administrationcenters for	228
medicare and medicaid services as part of the certification	229
process for the medicare program established under Title XVIII of	230
the "Social Security Act," 4979 Stat. 620286 (1935), 42 U.S.C.A.	231
3011395, as amended, and the medicaid program established under	232
Title XIX of that actthe "Social Security Act," 79 Stat. 286	233
(1965), 42 U.S.C. 1396.	234

(4) The director shall not establish a fee for any service	235
for which a licensure or inspection fee is paid by the health care	236
provider to a state agency for the same or similar licensure or	237
inspection.	238

Section 2. That existing sections 3702.30 and 3702.31 of the	239
Revised Code are hereby repealed.	240