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HOUSE AMENDED
A05170
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
818
Session of
2021
INTRODUCED BY J. WARD, MARTIN, PITTMAN, PHILLIPS-HILL, STEFANO,
MENSCH, BROWNE, BAKER, ARGALL, SCHWANK AND SCAVELLO,
JULY 26, 2021
AS REPORTED FROM COMMITTEE ON HEALTH, HOUSE OF REPRESENTATIVES,
AS AMENDED, APRIL 26, 2022
AN ACT
Amending the act of July 19, 1979 (P.L.130, No.48), entitled "An
act relating to health care; prescribing the powers and
duties of the Department of Health; establishing and
providing the powers and duties of the State Health
Coordinating Council, health systems agencies and Health Care
Policy Board in the Department of Health, and State Health
Facility Hearing Board in the Department of Justice;
providing for certification of need of health care providers
and prescribing penalties," in licensing of health care
facilities, providing for ambulatory surgical facility
permitted surgical procedures; AND ABROGATING REGULATIONS.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of July 19, 1979 (P.L.130, No.48), known
as the Health Care Facilities Act, is amended by adding a
section to read:
Section 822. Ambulatory surgical facility permitted surgical
procedures.
(a) Exception or waiver.--An ambulatory surgical facility
may seek an exception or waiver from the department for surgical
procedures not specified on the Centers for Medicare and
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Medicaid Services (CMS) Ambulatory Surgical Center Covered
Procedures List (ASC-CPL) on the effective date of this section
or otherwise provided by law or regulation.
(b) Permitted surgical procedures.--
An ambulatory surgical facility may perform surgical
procedures permitted under Federal or State law or regulation
and surgical procedures specified on the ASC-CPL on the
effective date of this section, if it does not conflict with
Federal or State law or regulation, without submitting a
request for an exception or waiver from the department for
approval.
(c) Publication of surgical procedures.--The department
shall transmit notice to the Legislative Reference Bureau for
publication in the Pennsylvania Bulletin of any updates to the
ASC-CPL made by the Centers for Medicare and Medicaid Services
(CMS) . The updates shall be transmitted by the department
separately as notices to the Legislative Reference Bureau for
publication in the Pennsylvania Bulletin. The department shall
publish and maintain the complete ASC-CPL on the department's
publicly accessible Internet website.
Section 2. The provisions of 28 Pa. Code § 551.21(d)(1), (2)
and (3) are abrogated. The provisions of 28 Pa. Code Chs. 51 and
551-571 are abrogated to the extent that they are inconsistent
with section 822 of the act.
Section 3. This act shall take effect in 60 days.
SECTION 1. THE ACT OF JULY 19, 1979 (P.L.130, NO.48), KNOWN
AS THE HEALTH CARE FACILITIES ACT, IS AMENDED BY ADDING A
SECTION TO READ:
S ECTION 822. AMBULATORY SURGICAL FACILITY PERMITTED SURGICAL
PROCEDURES.
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(A) EXCEPTION OR WAIVER.--AN AMBULATORY SURGICAL FACILITY
MAY SEEK AN EXCEPTION OR WAIVER FROM THE DEPARTMENT FOR ANY OF
THE FOLLOWING SURGICAL PROCEDURES:
(1) A SURGICAL PROCEDURE NOT SPECIFIED IN ASC-CPL.
(2) A SURGICAL PROCEDURE NOT PUBLISHED IN A NOTICE UNDER
SUBSECTION (C)(1).
(3) (2) A SURGICAL PROCEDURE OTHERWISE PROHIBITED BY
STATE REGULATION.
(B) PERMITTED SURGICAL PROCEDURES.--AN AMBULATORY SURGICAL
FACILITY MAY PERFORM ANY OF THE FOLLOWING SURGICAL PROCEDURES
WITHOUT SEEKING A REQUEST FOR AN EXCEPTION OR WAIVER OR
RECEIVING AN APPROVAL OF AN EXCEPTION OR WAIVER FROM THE
DEPARTMENT UNDER SUBSECTION (A):
(1) A SURGICAL PROCEDURE PERMITTED TO BE PERFORMED BY AN
AMBULATORY SURGICAL FACILITY UNDER FEDERAL OR STATE LAW OR
REGULATION.
(2) A SURGICAL PROCEDURE SPECIFIED IN ASC-CPL THAT DOES
NOT CONFLICT WITH A STATE LAW OR REGULATION.
(3) A SURGICAL PROCEDURE PUBLISHED IN A NOTICE UNDER
SUBSECTION (C)(1).
(C) PUBLICATION OF SURGICAL PROCEDURES.--
(1) WITHIN 45 DAYS OF THE EFFECTIVE DATE OF AN UPDATE TO
ASC-CPL MADE BY CMS, THE DEPARTMENT SHALL TRANSMIT NOTICE TO
THE LEGISLATIVE REFERENCE BUREAU FOR PUBLICATION IN THE
PENNSYLVANIA BULLETIN. THE NOTICE SHALL LIST THE SURGICAL
PROCEDURES SPECIFIED IN ASC-CPL AND THE UPDATE TO ASC-CPL
MADE BY CMS, EXCEPT FOR A SURGICAL PROCEDURE THAT IS
DISAPPROVED UNDER PARAGRAPH (2).
(2) FOR AN UPDATE TO ASC-CPL MADE BY CMS, THE DEPARTMENT
MAY DISAPPROVE A SURGICAL PROCEDURE IF THE DEPARTMENT FINDS
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THAT THE SURGICAL PROCEDURE WOULD CONFLICT WITH STATE LAW OR
REGULATION.
(3) IF THE DEPARTMENT DISAPPROVES A SURGICAL PROCEDURE
UNDER PARAGRAPH (2), THE DEPARTMENT SHALL SPECIFY THE STATE
LAW OR REGULATION AND THE REASONS FOR THE DISAPPROVAL IN EACH
NOTICE PUBLISHED UNDER PARAGRAPH (1) FOR THE DURATION WHEN
THE DEPARTMENT MAINTAINS THE DISAPPROVAL OF THE SURGICAL
PROCEDURE.
(4) UPON PUBLICATION OF THE NOTICE UNDER PARAGRAPH (1),
OR WITHIN 60 DAYS OF THE EFFECTIVE DATE OF AN UPDATE TO ASC-
CPL MADE BY CMS, WHICHEVER IS EARLIER, AN AMBULATORY SURGICAL
FACILITY MAY PERFORM A SURGICAL PROCEDURE THAT HAS NOT BEEN
DISAPPROVED BY THE DEPARTMENT UNDER PARAGRAPH (2).
(5) THE DEPARTMENT'S DISAPPROVAL OF A SURGICAL PROCEDURE
UNDER PARAGRAPH (2) SHALL NOT BE CONSTRUED AS PROHIBITING THE
DEPARTMENT'S APPROVAL OF AN EXCEPTION OR WAIVER UNDER
SUBSECTION (A).
(6) THE DEPARTMENT SHALL PUBLISH AND CONTINUALLY
MAINTAIN A COMPLETE LIST OF SURGICAL PROCEDURES FROM ASC-CPL
THAT MAY BE PERFORMED OR ARE PROHIBITED FROM BEING PERFORMED
BY AN AMBULATORY SURGICAL FACILITY ON THE DEPARTMENT'S
PUBLICLY ACCESSIBLE INTERNET WEBSITE.
(b) Review period.--
(1) Upon receipt of a request for an exception or waiver
under subsection (a), the department shall, within 60
calendar days, provide a written response to the ambulatory
surgical facility that approves or denies the request or
shall provide notice that the department is unable to issue a
determination because a substantive element is missing that
is necessary for the department to approve or deny the
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request.
(2) If the department denies the request, the department
shall include the basis for the denial, including statutory
or regulatory citations that form the basis of the denial.
(3) If the department determines that it is unable to
issue a determination, the department shall specify the
substantive element that is needed for the facility to
resubmit its request. Upon receipt of the facility's
resubmitted application, the department shall approve or deny
the resubmitted application within 60 calendar days of
receipt of the resubmitted application. The department shall
deny an incomplete resubmitted application.
(4) If the department does not approve, deny or provide
notice that the department is unable to issue a determination
on an initial application or does not approve or deny a
resubmitted application within 60 calendar days, the request
shall be deemed approved and the ambulatory surgical facility
may proceed as if the request has been approved by the
department.
(c) Permitted surgical procedures.--An ambulatory surgical
facility may perform surgical procedures permitted under Federal
or State law or regulation and surgical procedures specified on
the ASC-CPL on the effective date of this section t hat do not
otherwise conflict with State regulations relating to license
classification, construction and design standards, personnel,
equipment, governance and management and notification
requirements . The department may not require an ambulatory
surgical facility to request an exception or waiver or receive
an approval of an exception or waiver to 28 Pa. Code § 551.21(d)
(relating to criteria for ambulatory surgery) from the
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department for surgical procedures specified in ASC-CPL.
(D) DEFINITIONS.--AS USED IN THIS SECTION, THE FOLLOWING
WORDS AND PHRASES SHALL HAVE THE MEANINGS GIVEN TO THEM IN THIS
SUBSECTION:
"ASC-CPL." THE CMS 2022 AMBULATORY SURGICAL CENTER COVERED
PROCEDURES LIST, EFFECTIVE JANUARY 1, 2022.
"CMS." THE CENTERS FOR MEDICARE AND MEDICAID SERVICES.
"S ubstantive element." Material information necessary for
the department to approve or deny a request for an exception or
waiver.
SECTION 2. THE PROVISIONS OF 28 PA. CODE §§ 51.22 AND
551.21(D)(1), (2) AND (3) § 51.22 ARE ABROGATED. THE PROVISIONS
OF 28 PA. CODE CHS. 51 AND 551-571 ARE ABROGATED TO THE EXTENT
THAT THEY ARE INCONSISTENT WITH THE ADDITION OF SECTION 822 OF
THE ACT. NOTHING IN THIS SECTION SHALL BE CONSTRUED TO ABROGATE
REGULATIONS RELATING TO ENVIRONMENTAL SERVICES, FIRE AND SAFETY
SERVICES, CONSTRUCTION STANDARDS, PATIENT AND PEDIATRIC
STANDARDS, BOARD-CERTIFIED STANDARDS FOR PHYSICIANS AND
ANESTHESIA SERVICES. 28 Pa. Code § 551.21 are abrogated insofar
as they are inconsistent with the addition of section 822 of the
act.
SECTION 3. THIS ACT SHALL TAKE EFFECT IN 60 DAYS.
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