May 26, 2020

May 26, 2020

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Changes to Definition of Ambulatory Surgical Facilities to Impact Hospitals

Effective Oct. 17, 2019, hospital outpatient departments (HOPDs) and other facilities which previously were exempt from the Ambulatory Surgical Facility (ASF) licensure requirement may now meet the criteria of an ASF. Governor Mike DeWine’s budget bill contained provisions which modified the definition of an ASF and will expand the number of facilities subject to regulation under Ohio law as an ASF. 

Under the former definition of an ASF, only surgical facilities which functioned separately from a hospital’s inpatient surgical unit or office of a physician, or which held itself out (e.g., for billing or accreditation purposes) as an ASF or ambulatory surgical center were deemed to be ASFs under Ohio law. HOPDs, which operate as part of a hospital and are integrated with the hospital’s inpatient surgical unit, fell outside of the definition of an ASF and thus, were exempt from the ASF licensure requirement. 

The new ASF definition includes facilities in which: (1) surgical services are provided to patients who do not require hospitalization for inpatient care, (2) services are not provided to any patient for longer than 24 hours after the patient’s admission, and (3) one of the following applies:

a.  Surgical services are provided in a building where no inpatient care is provided; or

b.  Surgical services are provided in a building where inpatient care is provided, but the surgical services portion of the building is operated by a different entity; or

c.  The facility is held out as an ASF or similar facility.

These changes will expand the number of facilities that will be subject to regulation as an ASF. Hospitals and other facilities previously exempt from ASF licensure should seek legal counsel on the implications of these changes.

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About this Author

Stacey A. Borowicz, Regulatory, Health care industry, attorney, Dinsmore Shohl,

Stacey Borowicz is an accomplished attorney who dedicates the majority of her business and regulatory practice to health care providers. Stacey brings with her more than a decade of front line experience in the health care industry as she acquired a rare set of skills as a medical researcher/scientist prior to entering the practice of law.

Stacey's experience in the healthcare representation is diverse and includes Medicare/Medicaid audit and overpayment appeals, voluntary disclosures and refunds. Stacey also brings a wealth of experience in...

Eric J. Plinke, Dinsmore Law, Health Care Lawyer, Corporate Attorney

Eric Plinke is a Partner in the Corporate Department and Health Law Practice Group, and he routinely advises corporate and individual clients regarding a wide-range of health care industry legal issues. He has counseled clients in practice formation and acquisition, hospital and joint venture transactions, hospital and medical practice affiliations, contract review and preparation, compliance programs, HIPAA regulations, scope of practice issues, telemedicine and Stark law and Anti-kickback statutes, as well as significant experience counseling in ambulatory surgery centers and other joint ventures. He also has successfully represented both entities and providers in credentialing, medical staff matters and third-party payor audits, and has extensive experience representing entities and providers in regulatory investigations and hearings. 

Courtney White, Dinsmore Law Firm, Corporate Attorney

Courtney is a member of our Corporate Department where she focuses her practice on health care law.

While at the Ohio State University Moritz College of Law, she was a managing editor on the Ohio State Law Journal. She also earned the Ernest Karam Book Award for academic achievement in Legal Analysis and Writing and was named a Public Service Fellow with Dean’s Special Recognition.