Here’s a link to the current Department of Public Health Determination of Need Regulations: https://www.mass.gov/doc/105-cmr-100-determination-of-need
Here’s a link to the current DPH Clinic Licensure regulations:
Determination of Need (DoN) regulations effective January 27, 2017 eliminate a 20-year moratorium on free-standing ambulatory surgery centers in the Commonwealth and will allow all currently licensed ASC’s to apply for a DoN certificate without affiliation or in a joint venture with an acute care hospital. The affiliation/joint venture provision was a requirement of draft regulations but was eliminated from the final regulations after strong opposition from the MAASC, physicians, and insurers.
All facilities licensed in 2017 are grandfathered in and allowed to apply for a DoN without affiliation or in a joint venture with an acute care hospital. Multi-specialty facilities are allowed to add a new service line, expand the facility and transfer ownership. Same for single specialty facilities but those wishing to become multi-specialty would have to affiliate with a Health Policy Commission certified Accountable Care Organization (ACO). Construction of a free-standing ASC at a new location must be done by an Applicant working either in joint venture with an HPC-certified ACO or by an existing independent community hospital. Additionally, any entities seeking to locate a new free-standing ASC location within the primary service area of one of the Commonwealth’s 10 remaining independent community hospitals (i.e. independent, non-affiliated), the entity would be required to either obtain a letter of support from the independent community hospital, or engage in a joint venture/affiliation with the independent community hospital. It should be noted that according HPC’s Massachusetts Hospital Cohort Designation and Affiliation Status, only 10 independent community hospitals are currently in operation, limiting this provision’s scope. Lastly, the new regulations simplify and speed up the DoN process for all applicants.
The Massachusetts Legislature will enter the second year of the 2019/2020 state legislative session on January 1, 2020. All bill pending before the legislature in 2019 will carry over to 2020.
The Massachusetts House and Senate has announced its intent to address health care reform/cost containment in 2020. In 2018, the House of Representatives included a tax on ASC’s as a funding mechanism for community hospitals. That bill died in Conference Committee at the end of the session on July 31, 2018. Although no such tax provisions currently exist in any House or Senate proposal, it is likely that the issue will be raised again in legislation expected in early 2020. The MAASC is monitoring the House and Senate closely and sharing information on the value of freestanding ASC’s to patients, providers and insurers. So stay tuned, more to come!!
OUR MEMBER SPECIALTIES
Surgery that does not require an overnight hospital stay.
Surgery which uses a laser instead of a scalpel to cut tissue. There are several type of laser surgery including soft tissue laser surgery, laser resurfacing, LASIK and photoreflective keratectomy.
Cosmetic surgery is an optional procedure performed with the sole purpose of improving a patient’s appearance.
Reconstructive surgery is done to restore form and function of the body due to trauma or after an event such as cancer treatment.
A procedure in which an instrument called an endoscope is used to look inside the body.
Medical programs and techniques designed to ease the suffering of patients, improving the quality of life for those in pain.
Surgery performed on the eye. Different eye surgery procedures are: cataract, glaucoma. refractive, corneal, vitreo-retinal, eye muscle, oculoplastic and others.