HLT-39-10-00005-P Post Anesthesia Evaluations at Free-Standing and Hospital Off-Site Ambulatory Surgery Centers (ASCs)

9/29/10 N.Y. St. Reg. HLT-39-10-00005-P

NEW YORK STATE REGISTER

VOLUME XXXII, ISSUE 39

September 29, 2010

RULE MAKING ACTIVITIES

DEPARTMENT OF HEALTH

PROPOSED RULE MAKING

NO HEARING(S) SCHEDULED

 

I.D No. HLT-39-10-00005-P

Post Anesthesia Evaluations at Free-Standing and Hospital Off-Site Ambulatory Surgery Centers (ASCs)

PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following proposed rule:

Proposed Action:

Amendment of section 755.6 of Title 10 NYCRR.

Statutory authority:

Public Health Law, section 2803

Subject:

Post Anesthesia Evaluations at Free-Standing and Hospital Off-Site Ambulatory Surgery Centers (ASCs).

Purpose:

Authorize those individuals who can administer anesthesia in Free-Standing and Hospital Off-Site ASCs to do post anesthesia evaluations.

Text of proposed rule:

The title of Part 755 is amended to read as follows:

PART 755

FREE-STANDING AND OFF-SITE HOSPITAL BASED AMBULATORY SURGERY SERVICES

Subdivision (d) of Section 755.6 of Part 755 is amended to read as follows:

(d) each patient is evaluated by a physician or by an individual qualified to administer anesthesia as set forth in subdivision (c) in Section 755.4 of this Part for proper anesthesia recovery, and discharged upon the written order of a physician;

Text of proposed rule and any required statements and analyses may be obtained from:

Katherine Ceroalo, DOH, Bureau of House Counsel, Regulatory Affairs Unit, Room 2438, ESP, Tower Building, Albany, NY 12237, [phone], email: [e-mail]

Data, views or arguments may be submitted to:

Same as above.

Public comment will be received until:

45 days after publication of this notice.

Regulatory Impact Statement

Statutory Authority:

The statutory authority for the promulgation of this regulation is contained in Public Health Law (PHL) section 2803(2) which authorizes the State Hospital Review and Planning Council (SHRPC) to adopt and amend rules and regulations, subject to the approval of the Commissioner, to implement the purposes and provisions of PHL Article 28, and to establish minimum standards governing the operation of health care facilities.

Legislative Objectives:

The legislative objective of PHL Article 28 includes the protection and promotion of the health of the residents of New York State by requiring the efficient provision and proper utilization of health services, of the highest quality at a reasonable cost.

Needs and Benefits:

Currently only a physician is authorized to evaluate each patient for proper anesthesia recovery in free-standing and hospital off-site ambulatory surgery centers (ASCs) in New York State. A recent federal regulatory change (42 Code of Federal Regulations (CFR) Section 416.42) specifies that in the ASC setting the post anesthesia assessment must be completed and documented by a physician or anesthetist, certified registered nurse anesthetist (CRNA) or an anesthesiologist's assistant.

Section 755.4 of Title 10 of the New York Codes Rules and Regulations (10 NYCRR) sets forth the anesthesia services provisions for free-standing and hospital off-site ASCs in New York State. These provisions specify that anesthesia can be administered only by a qualified anesthesiologist, or a physician or dentist qualified to administer anesthesia, or a certified registered nurse anesthetist. As dentists (the federal definition of a physician pursuant to Section 1861 of the Social Security Act includes dentists) and CRNAs can conduct the post anesthesia requirements pursuant to federal regulation, current provisions in Section 755.6 (Patient Admission and Discharge) need to be updated to conform to the recent federal changes. The language in Section 755.6 of Title 10 NYCRR should mirror the language in Section 755.4 of Title 10 NYCRR. The same individuals who are qualified to administer anesthesia in ASCs in New York State should be the same individuals who are qualified to conduct the post anesthesia assessments.

The Title of Part 755 has been amended to accurately reflect the types of facilities applicable to Part 755 as specified in the ambulatory surgery definition set forth in Section 755.1.

Costs:

This provision would not increase costs to State or local governments, the State or local health departments or providers. This measure would allow the same individuals who are able to administer anesthesia in New York State free-standing or hospital off-site ASCs also to do the post evaluation anesthesia assessment.

Local Government Mandates:

This provision does not impose any additional mandates on local governments.

Paperwork:

There is no additional paperwork required as a result of this proposal.

Duplication:

This regulation does not duplicate any other State or federal regulation.

Alternatives:

One option considered was not to make any changes to these provisions. The Department chose, however, to amend these provisions to conform to federal changes in 42 CFR Section 416.42.

Federal Standards:

This measure does not exceed any minimum standards of the federal government for the same or similar subject areas. It conforms to changes in 42 CFR Section 416.42. 42 CFR Section 416.42 also allows anesthesiologist assistants to do post anesthesia assessments. New York State does not recognize anesthesiologist assistants. New York State does allow dentists qualified to administer anesthesia.

Compliance Schedule:

This proposed amendment will become effective upon publication of a Notice of Adoption in the New York State Register.

Regulatory Flexibility Analysis

Effect of Rule:

This regulation impacts 92 free-standing and 20 hospital off-site ASCs in New York State. All of the 92 free-standing ASCs are small businesses.

Compliance Requirements:

This proposal allows practitioners, in addition to physicians, who are already authorized to administer anesthesia in the free-standing and hospital off-site ASC setting pursuant to Title 10 Section 755.4 to also do a post anesthesia assessment.

Professional Services:

There are no additional professional services required to comply with this proposal.

Compliance Costs:

None.

Economic and Technological Feasibility:

This proposal is economically the technologically feasible.

Minimizing Adverse Impact:

There is no adverse impact.

Small Business and Local Government Participation:

Outreach to the affected parities is being conducted. Organizations who represent the affected parities and the public can also obtain the agenda of the Codes and Regulations Committee of the State Hospital Review and Planning Council (SHRPC) and the proposed regulation on the Department's website. The public, including any affected party, is invited to comment during the Codes and Regulations Committee meeting.

Rural Area Flexibility Analysis

No Rural Area Flexibility Analysis is required pursuant to section 202-bb(4)(a) of the State Administration Procedure Act (SAPA). It is apparent, from the nature of the proposed amendment that it will not impose any adverse impact on rural areas, and the rule does not impose any new reporting, recordkeeping or other compliance requirements on public or private entities in rural areas.

Job Impact Statement

No Job Impact Statement is required pursuant to section 201-a (2) (a) of the State Administration Procedure Act (SAPA). It is apparent, from the nature of the proposed amendment, that it will have no impact on jobs and employment opportunities.