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Am. S. B. No. 124As Passed by the SenateAs Passed by the Senate
124th General Assembly | Regular Session | 2001-2002 |
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SENATORS Jordan, Amstutz, Austria, DiDonato, Randy Gardner, Harris, Hottinger, Jacobson, Spada, Wachtmann, Ryan
A BILL
To amend sections 3702.30 and 3702.31 and to enact
section 3702.32 of the Revised Code relative to
sanctions for a health care facility's violations
of licensing requirements and quality standards,
injunctions to enjoin such violations, information
and informed consent compliance
requirements for
ambulatory
surgical facility physicians, and
expanded health
care facility rule making
authority
of the
Director of Health.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 3702.30 and 3702.31 be amended and
section 3702.32 of the Revised Code be enacted to read as follows:
Sec. 3702.30. (A) As used in this section: (1) "Ambulatory surgical facility" means a facility,
whether
or not part of the same organization as a hospital, that
is
located in a building distinct from
another in which inpatient
care is provided, and to which any of the
following apply: (a) Outpatient surgery is routinely performed in the
facility, and
the facility functions separately from a
hospital's
inpatient surgical service and from the offices of private
physicians, podiatrists, and dentists;. (b) Anesthesia is administered in the facility by
an
anesthesiologist or certified registered nurse anesthetist,
and
the facility functions separately from a hospital's inpatient
surgical
service and from the offices of private physicians,
podiatrists, and
dentists;. (c) The facility applies to be certified by the
United
States health care financing
administration as an ambulatory
surgical center for purposes of
reimbursement under Part B of the
medicare
program, Part B of Title XVIII
of the "Social Security
Act," 49 Stat. 620 (1935),
42 U.S.C.A. 301, as amended;. (d) The facility applies to be certified by a
national
accrediting body approved by the health care financing
administration for purposes of deemed compliance with the
conditions for participating in the medicare program as an
ambulatory surgical center;. (e) The facility bills or receives from any
third-party
payer, governmental health care program, or other person or
government entity any ambulatory surgical
facility fee that is
billed or paid in addition to any fee for
professional services;. (f) The facility is held out to any person or government
entity as an ambulatory surgical facility or similar facility by
means of
signage, advertising, or other promotional efforts. "Ambulatory surgical facility" does not include
a hospital
emergency department. (2) "Ambulatory surgical facility
fee" means a fee for
certain overhead costs associated with
providing surgical services
in an outpatient setting. A fee is
an ambulatory surgical
facility fee only if it directly or
indirectly pays for costs
associated with any of the following: (a) Use of operating and recovery rooms,
preparation areas,
and waiting rooms and lounges for patients and
relatives; (b) Administrative functions, record keeping,
housekeeping,
utilities, and rent; (c) Services provided by nurses, orderlies,
technical
personnel, and others involved in patient care related
to
providing surgery. "Ambulatory surgical facility fee" does
not include any
additional payment in excess of a professional
fee that is
provided to encourage physicians, podiatrists, and
dentists to
perform certain surgical procedures in their office
or their group
practice's office rather than a health care
facility, if the
purpose of the additional fee is to compensate
for additional cost
incurred in performing office-based surgery. (3) "Governmental health care program" has the same
meaning
as in section 4731.65 of the Revised Code. (4) "Health care facility" means any of the following: (a) An ambulatory surgical facility; (b) A freestanding dialysis center; (c) A freestanding inpatient rehabilitation facility; (d) A freestanding birthing center; (e) A freestanding radiation therapy center; (f) A freestanding or mobile diagnostic imaging center. (5)
"Metropolitan statistical area"
has the same meaning as
in section 3702.51 of the Revised Code. (6) "Third-party payer" has the same meaning as in
section
3901.38 of the Revised Code.
(B) By rule adopted in accordance with sections
3702.12 and
3702.13 of the Revised Code, the
director of health shall
establish quality standards for health care
facilities. The
standards may incorporate accreditation standards or other
quality
standards established by any entity recognized by the director.
The
rules shall be adopted so as to cause the standards to take
effect on
March 31, 1996. (C)
Every ambulatory surgical facility shall require
that
each physician who practices at the facility comply with all
relevant provisions in the Revised Code that relate to the
obtaining of informed consent
from a patient.
(D) The director shall issue a license to each health care
facility that makes application for a license and demonstrates to
the director
that it meets the quality standards established
by
the rules adopted under division (B) of
this section, except that
if a health care facility located in a metropolitan
statistical
area applies for a license on or after
March
31, 1996, and at the
time the license is to take effect
the quality standards
are not
yet in effect, the director shall issue the license without a
demonstration that the health care facility meets quality
standards
and satisfies the informed consent
compliance
requirements specified in division (C) of this section. (D)(E) No
health
care facility shall operate without a
license issued under this section.
(E)(F) The rules adopted under division
(B) of this section
shall include
provisions
all of the following:
(1) Provisions governing
application for, renewal,
suspension, and revocation of
licenses
a license under this
section; (2) Provisions governing orders issued pursuant to section
3702.32 of the Revised Code for a health care facility to cease
its operations or to prohibit certain types of services provided
by a health care facility;
(3) Provisions governing the imposition under section
3702.32 of the Revised Code of civil penalties for violations of
this section or the rules adopted under this section, including a
scale for determining the amount of the penalties.
Sec. 3702.31. (A) The quality monitoring and
inspection
fund is hereby created in the state treasury. The
director of
health shall use the fund to
administer and enforce this section
and sections
3702.11 to 3702.20
and, 3702.30, and 3702.32 of the
Revised
Code and rules adopted pursuant to those sections.
The
director shall deposit in the fund any moneys
collected pursuant
to this section
or section 3702.32 of the Revised Code. All
investment earnings of
the fund shall be credited to the fund. (B) The director of health shall adopt rules pursuant to
Chapter 119. of the Revised Code establishing fees
for both of the
following: (1) Initial and renewal license applications submitted under
section
3702.30 of the Revised Code. The fees established under
division (B)(1) of this section shall not
exceed the actual and
necessary costs of performing the
activities described in division
(A) of this section. (2) Inspections conducted
under section 3702.15 or 3702.30
of the
Revised
Code. The fees established
under division (B)(2)
of this
section shall not exceed the actual and necessary costs
incurred
during an inspection, including any indirect costs
incurred by
the department for staff, salary, or other
administrative
costs.
The director of health shall provide to
each health
care facility or provider inspected pursuant to
section 3702.15
or 3702.30 of the Revised
Code a written statement
of the
fee.
The statement shall itemize and total the costs
incurred.
Within fifteen days after receiving a
statement from
the director, the facility or provider shall
forward the total
amount of the fee to the director. (3) The fees described in divisions
(B)(1) and (2) of this
section
shall meet both of the following requirements: (a) For each service described in
section 3702.11 of the
Revised
Code, the fee shall not exceed
one thousand
dollars two
hundred fifty
dollars annually, except that the total fees
charged
to a
health care provider under this section shall not exceed five
thousand dollars
annually. (b) The fee shall exclude any costs
reimbursable by the
United
States health care financing
administration as part of the
certification process for the
medicare program established under
Title
XVIII of the
"Social
Security
Act," 49
Stat. 620 (1935), 42
U.S.C.A.
301, as amended, and the medicaid program established
under
Title
XIX of that act. (4) The director shall not establish a fee for any
service
for which a licensure or inspection fee is paid by the
health care
provider to a state agency for the same or similar
licensure or
inspection.
Sec. 3702.32. (A) If the director of health determines that
a health care facility is operating without a license in violation
of division (E) of section 3702.30 of the Revised Code, the
director shall do one or more of the following: (1) Issue an order that the health care facility cease its
operations;
(2) Issue an order that prohibits the health care facility
from performing certain types of services; (3) Impose a civil penalty of not less than one thousand
dollars and not more than two hundred fifty thousand dollars upon
the health care facility for operating without a license; (4) Impose an additional civil penalty of not less than one
thousand dollars and not more than ten thousand dollars for each
day that the health care facility operates without a license. (B)(1) If a health care facility subject to an order issued
under division (A)(1) of this section continues to operate, the
director of health may file a petition in the court of common
pleas of the county in which the health care facility is located
for an injunction enjoining the facility from operating. The
court shall grant an injunction upon a showing that the respondent
named in the petition is operating without a license. (2) If a health care facility subject to an order issued
under division (A)(2) of this section continues to provide the
types of services prohibited by the order, the director of health
may file a petition in the court of common pleas of the county in
which the health care facility is located for an injunction
enjoining the facility from performing those types of services.
The court shall grant an injunction upon a showing that the
respondent named in the petition is providing the types of
services prohibited by the director's order. (C) If the director of health determines that a health care
facility has violated any provision of section 3702.30 of the
Revised Code, other than a violation of division (E) of that
section, any provision of Chapter 3701-83 of the Administrative
Code, or any other rule adopted by the director of health under
section 3702.30 of the Revised Code, the director may do any or
all of the following: (1) Revoke, suspend, or refuse to renew the health care
facility's license; (2) Prior to or during the pendency of an administrative
hearing under Chapter 119. of the Revised Code, issue an order
that prohibits the health care facility from performing certain
types of services; (3) Provide an opportunity for the health care facility to
correct the violation; (4) Impose a civil penalty of not less than one thousand
dollars and not more than two hundred fifty thousand dollars upon
the health care facility for the violation; (5) Impose an additional civil penalty of not less than five
hundred dollars and not more than ten thousand dollars for each
day that the health care facility fails to correct the violation. (D) If a health care facility subject to an order issued
under division (C)(2) of this section continues to provide the
types of services prohibited by the order, the director of health
may file a petition in the court of common pleas of the county in
which the facility is located for an injunction enjoining the
facility from performing those types of services. The court shall
grant an injunction upon a showing that the respondent named in
the petition is providing the types of services prohibited by the
director's order. (E) The director shall deposit all moneys collected as civil
penalties under this section into the quality monitoring and
inspection fund created under section 3702.31 of the Revised Code
for use in accordance with that section.
Section 2. That existing sections 3702.30 and 3702.31 of the
Revised Code are hereby repealed.
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