Beth LaBouyer, executive director of California Ambulatory Surgery Association, joined Becker’s to discuss these policies.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Are there any state-specific regulations or legislative initiatives that are significantly helping or hindering the expansion of ASCs?
Beth LaBouyer: California state law currently restricts cardiac catheterization procedures to acute care hospitals. CMS approved these procedures for ASCs in 2019, and California is one of the few states prohibiting them in ASCs. These rules are outdated and place unnecessary limitations on the role that ASCs could play in increasing access to care. Allowing ASCs to provide cardiac catheterization and PCI procedures will increase patient access to care in a lower-cost setting, while enabling hospitals to accommodate increasing demand for hospital dependent services.
Additionally, we are concerned about legislation that was introduced previously in California, AB 3129, aimed at adding additional regulation on the health system by requiring consent from the attorney general for mergers or acquisitions, with a focus on private equity firms and hedge funds. That legislative initiative would have created a series of harmful effects to the industry. We are watching the legislature this year to see if those proposals emerge again and remain concerned about the impact to ASCs.
Q: What is the current status of certificate-of-need laws in your state, and how do they impact ASC development and access to care?
BL: California does not have CON laws. Instead, we have the Office of Healthcare Affordability, which is tasked with trying to control healthcare costs, assess resource needs, and analyze market consolidation issues. OHCA established new disclosure requirements for healthcare marketplace transactions including mergers and acquisitions. We are concerned that OHCA’s regulations may be overly broad and could impede important market actions that would be necessary for providing access to care for California patients.
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