SENATE HEALTH, HUMAN SERVICES AND SENIOR CITIZENS COMMITTEE

STATEMENT TO

SENATE, No. 2780

with committee amendments

STATE OF NEW JERSEY

DATED: MAY 26, 2011

      The Senate Health, Human Services and Senior Citizens Committee reports favorably and with committee amendments Senate Bill No. 2780.

      As amended by committee, this bill requires all “surgical practices” to be licensed by the Department of Health and Senior Services (DHSS) as ambulatory surgery facilities within one year of the date of enactment of the bill.

      A "surgical practice" is defined as a structure or suite of rooms that has the following characteristics:

-- has no more than one room dedicated for use as an operating room which is specifically equipped to perform surgery, and is designed and constructed to accommodate invasive diagnostic and surgical procedures;

-- has one or more post-anesthesia care units or a dedicated recovery area where the patient may be closely monitored and observed until discharged; and

-- is established by a physician, physician professional association surgical practice, or other professional practice form specified by the State Board of Medical Examiners pursuant to regulation solely for the physician's, association's or other professional entity's private medical practice.

      Pursuant to P.L.2009, c.24, all surgical practices were required to register with DHSS by March 21, 2010, and be subject to limited oversight by DHSS.  These one-operating room, physician-owned practices, however, provide the same type of surgical services as the larger, licensed ambulatory surgery facilities.

      This bill, therefore, repeals the requirement that surgical practices be registered by DHSS, and provides, instead, that surgical practices must be licensed by DHSS within one year as ambulatory care facilities licensed to provide surgical and related services and be subject to the same regulatory requirements as the larger ambulatory surgical facilities.  The bill provides, however, that:

-- A surgical practice may apply to DHSS for a waiver of one or more physical plant requirements in accordance with N.J.A.C.8:43A-2.9, and the Commissioner of DHSS shall grant the waiver of those requirements as the commissioner deems appropriate, if the waiver does not endanger the life, safety, or health of patients or the public; and

-- If the entity does not charge patients or third party payers a facility fee, room charge, or other similar fee or charge, it shall be exempt from the ambulatory care facility assessment pursuant to section 7 of P.L.1992, c.160 (C.26:2H-18.57); except that, if the entity expands to include any additional rooms dedicated for use as an operating room, the entity shall be subject to the assessment regardless of whether it charges patients and third party payers a facility fee, room charge or other similar fee or charge.

      Finally, the bill directs the DHSS, to consult with physician-owners of surgical practices and their representatives, within 90 days of the effective date of the bill, regarding physical plant differences between single operating room surgical facilities and multiple operating room ambulatory care facilities, and to adopt such rules and regulations, pursuant to the “Administrative Procedure Act,” as it deems necessary to carry out the purposes of this act.

      The committee amended the bill to:

      -- provide that a surgical practice may apply to DHSS for a waiver of one or more physical plant requirements;

      -- exempt a one-operating room surgical practice that does not charge patients or third party payers a facility fee or other similar charge from the ambulatory care facility assessment pursuant to section 7 of P.L.1992, c.160 (C.26:2H-18.57);

      -- require ambulatory care facilities licensed to provide surgical and related services and surgical practices to report to DHSS, within 30 days, any change in ownership of the facility and any change in the medical director, physician director, physician director of anesthesia and director of nursing services.  The facilities are also required to report annually to DHSS the names of the facilities’ medical, physician, and nursing directors;

      -- direct DHSS to consult with physician-owners of surgical practices and their representatives regarding physical plant differences between single operating room surgical facilities and multiple operating room ambulatory care facilities, and adopt rules and regulations it deems necessary to implement the purposes of the bill; and

      -- delete the term “registered” in references to surgical practices in subsection i of section 1 of the bill.