Campanella, Gina L., JD,MHA

English

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Petersheim Academic Exposition Petersheim Academic Exposition
4-2012
Quality of Care in Ambulatory Surgical Centers
Gina L. Campanella JD,MHA
Seton Hall University
Follow this and additional works at: https://scholarship.shu.edu/petersheim-exposition
Part of the Health and Medical Administration Commons
Recommended Citation
Campanella, Gina L. JD,MHA, "Quality of Care in Ambulatory Surgical Centers" (2012). Petersheim Academic Exposition. 29.
https://scholarship.shu.edu/petersheim-exposition/29
Gina L. Campanella, JD, MHA 
Seton Hall University 
Master of Healthcare Administration 
• Freestanding ASCs (those not affiliated or owned by a 
hospital) “have increased from about 400 in 1983 to over 
3,300 in 2001” throughout the country (Bian & Morrisey 
2006, p. 111). 
 
• Forty-three states, including New Jersey, require 
Ambulatory Surgical Centers to obtain a state license 
(NJAASC 2011, p.2) 
 
• If an ASC wishes to accept Medicare or Medicaid, it must 
also meet separate federal regulations (NJAASC 2011, 
p.2) 
• Multi OR “ASCs must satisfy very specific criteria 
regarding patient safety mechanisms, infection 
prevention, staff qualifications, facility policies and 
procedures and physical plant requirements, including 
Life Safety Code compliance” (NJAASC 2011, p.2). 
   
• Licensed facilities are inspected the Department of 
Health and Senior Services prior to licensure and at 
least every two years thereafter.  
• An ASC that provides Medicare/Medicaid care must obtain 
certification through a private certification authority:  
• Joint Commission 
• Accreditation Association for Ambulatory Health Care 
• American Osteopathic Association 
• American Association for Accreditation of Ambulatory Surgical Facilities.   
 
• One OR facilities must be approved by one of these 
organizations regardless of Medicare status. 
• Codey Law (New Jersey Anti-Self Referral Statute) 
• until 2009 – no significant effect (Patterson & Albright 2010, p. 20) 
 
• Garcia v. Health Net of New Jersey, Inc., 2007 WL 5253484 
(Ch. Div. 2007), provided judicial interpretation that clearly 
prohibited physician self-referral to ASCs in which they had an 
ownership interest (Patterson & Albright 2010, p. 20). 
 
• Codey Law was immediately amended to preserve the 
exception for ASCs  
• Moratorium on the issuance of new licenses to ASCs 
except: 
 
• change of ownership of an existing center 
• relocation of an ASC to within 20 miles or to a “Health 
Enterprise Zone”  
• entities owned in whole or in part by a New Jersey hospital 
• entities owned in whole or in part by a New Jersey medical 
school 
 
0% 20% 40% 60% 80% 100% 120%
Federal Regulations
State Regualtions
Proficiency of Care
Rate of Unexpected Events
Cost of Care (est.)
Patient Satisfaction (est.)
Hospitals ASCs
Comparison of Hospitals and Ambulatory Surgical Centers 
• “Medicare pays more for some procedures in an ASC than in a 
hospital outpatient surgery department setting and vice versa, 
but according to recent reports by the OIG and the Medicare 
Payment Advisory Commission (MedPAC), it is unlikely that 
the ASC payments, at least, accurately reflect cost” (Casalino, 
et. al. 2011, p. 60).   
 
• Insurance companies must be called to the table to account for 
these payment discrepancies. 


Quality of Care in Ambulatory Surgical Centers

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Seton Hall UniversityeRepository @ Seton HallPetersheim Academic Exposition Petersheim Academic Exposition4-2012Quality of Care in Ambulatory Surgical CentersGina L. Campanella JD,MHASeton Hall UniversityFollow this and additional works at: https://scholarship.shu.edu/petersheim-expositionPart of the Health and Medical Administration CommonsRecommended CitationCampanella, Gina L. JD,MHA, "Quality of Care in Ambulatory Surgical Centers" (2012). Petersheim Academic Exposition. 29.https://scholarship.shu.edu/petersheim-exposition/29Gina L. Campanella, JD, MHA Seton Hall University Master of Healthcare Administration • Freestanding ASCs (those not affiliated or owned by a hospital) “have increased from about 400 in 1983 to over 3,300 in 2001” throughout the country (Bian & Morrisey 2006, p. 111).  • Forty-three states, including New Jersey, require Ambulatory Surgical Centers to obtain a state license (NJAASC 2011, p.2)  • If an ASC wishes to accept Medicare or Medicaid, it must also meet separate federal regulations (NJAASC 2011, p.2) • Multi OR “ASCs must satisfy very specific criteria regarding patient safety mechanisms, infection prevention, staff qualifications, facility policies and procedures and physical plant requirements, including Life Safety Code compliance” (NJAASC 2011, p.2).    • Licensed facilities are inspected the Department of Health and Senior Services prior to licensure and at least every two years thereafter.  • An ASC that provides Medicare/Medicaid care must obtain certification through a private certification authority:  • Joint Commission • Accreditation Association for Ambulatory Health Care • American Osteopathic Association • American Association for Accreditation of Ambulatory Surgical Facilities.    • One OR facilities must be approved by one of these organizations regardless of Medicare status. • Codey Law (New Jersey Anti-Self Referral Statute) • until 2009 – no significant effect (Patterson & Albright 2010, p. 20)  • Garcia v. Health Net of New Jersey, Inc., 2007 WL 5253484 (Ch. Div. 2007), provided judicial interpretation that clearly prohibited physician self-referral to ASCs in which they had an ownership interest (Patterson & Albright 2010, p. 20).  • Codey Law was immediately amended to preserve the exception for ASCs  • Moratorium on the issuance of new licenses to ASCs except:  • change of ownership of an existing center • relocation of an ASC to within 20 miles or to a “Health Enterprise Zone”  • entities owned in whole or in part by a New Jersey hospital • entities owned in whole or in part by a New Jersey medical school  0% 20% 40% 60% 80% 100% 120%Federal RegulationsState RegualtionsProficiency of CareRate of Unexpected EventsCost of Care (est.)Patient Satisfaction (est.)Hospitals ASCsComparison of Hospitals and Ambulatory Surgical Centers • “Medicare pays more for some procedures in an ASC than in a hospital outpatient surgery department setting and vice versa, but according to recent reports by the OIG and the Medicare Payment Advisory Commission (MedPAC), it is unlikely that the ASC payments, at least, accurately reflect cost” (Casalino, et. al. 2011, p. 60).    • Insurance companies must be called to the table to account for these payment discrepancies. 

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Quality of Care in Ambulatory Surgical Centers

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