In California, as elsewhere in the U.S., ambulatory surgical centers have been wildly successful, and their numbers have been expanding rapidly. As of 2005, there were about 4,500 in operation, compared with 2,786 just six years earlier. But since March 2007, when a physician challenged the jurisdiction of the state's Department of Public Health over his clinic, their legal status has been called into question. With the courts deciding that the DPH didn't have jurisdiction over ASCs with physician ownership, the agency stopped issuing new licenses for them. Since then, several difficult problems have arisen.
The state legislature may have solved one problem just recently by approving a measure allowing the state pharmacy board to grant limited licenses to clinics to purchase pain drugs wholesale. Without this legislation, which is headed for the governor's desk, the unlicensed clinics had problems purchasing drugs.
Another, more troubling issue has been that with the uncertainty over licensure, some health insurers have decided that they shouldn't have to pay the ASCs--even in the case of centers that see Medicare patients and face federal oversight. In many cases, health insurers have been convinced to pay their bill when they receive a warning letter from an attorney, but sometimes ASCs still face long payment delays under these circumstances, they note. Meanwhile, to address the licensure gap in a way that soothes insurers, many ASCs are seeking accreditation from the Accreditation Association for Ambulatory Health Care.
To learn more about California ASCs' situation:
- read this East Bay Business Times piece
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