II. ANTI-KICKBACK AND SELF-REFERRAL ISSUES
III. TAX EXEMPTION AND TAX-RELATED ISSUES
IV. STATE SELF-REFERRAL ISSUES
VI. MEDICARE CERTIFICATION, LICENSING, AND CON ISSUES FOR ASCs
VII. ANTITRUST CONSIDERATIONS AFFECTING ASCs.
EXHIBITS Exhibit 1: ASC Safe-Harbor Regulations of the Anti-Kickback Statute
Exhibit 2: Sample Compliance Plan Cover Letter
Exhibit 3: Sample Operating Agreement
Exhibit 4: Sample Compliance Policy Plan
Exhibit 5: Sample Policy for Antitrust Compliance
Ambulatory Surgery Centers: Legal and Regulatory Issues addresses the unique nature of ASCs, emphasizing their physical and organizational separation from other providers, regardless of whether they are owned by a hospital, a physician practice, or other entity. In this newly-revised and updated edition, the authors address the history behind the development of ambulatory surgery centers (ASCs) and their rapid growth since Medicare approved payments to them in 1982. Today there are more than 5,900 ASCs operating in this country. This new edition focuses on current issues for ASCs, and offers practical and useful guidance for those involved in giving legal advice to them.
The authors extensively discuss the following subjects:
• The unique nature of ASCs, emphasizing their physical and organizational separation from other providers;
• Key trends and tensions facing ASCs, such as the points of conflict that often arise between ASCs, hospitals, and physicians;
• Medicare and Medicaid fraud and abuse concerns, tax exemption and other tax-related issues, and the safe harbors for ASCs;
• Relevant Stark issues, as well as the impact of state self-referral laws;
traditional and current payment methods, and key reimbursement issues;
• Requirements for Medicare certification, licensing, and certificate-of-need issues; and
• Antitrust considerations for ASCs that face often-intense competition and exclusive contracting between hospital systems and payors.
Health Lawyers commends this monograph to all health attorneys and other healthcare professionals who wish understand the advantages and drawbacks of establishing and participating in ASCs.
Scott Becker, Esquire
Sarah Abraham Chacko, Esquire
Ronald E. Lundeen, Jr., Esquire
Elissa Koch Moore, Esquire
Melissa Szabad, Esquire
Gretchen Heinze Townshend, Esquire
Amber McGraw Walsh, Esquire
The authors are with the law firm McGuire Woods LLP, and focus their practices on regulatory and transactional matters in the healthcare arena.