(a) Ambulatory surgery services may be utilized by the program as a cost-efficient means of providing surgical care as long as quality of care is assured. Any hospital participating in the program whose accreditation by the Joint Commission includes hospital-sponsored ambulatory care services may provide ambulatory surgery services for program clients. The program will reimburse only approved ambulatory surgical care facilities for services to clients.
(b) Freestanding ambulatory surgical care (ASC) facilities, even if governed by or affiliated with a hospital participating in the program, must apply for program approval. The program may contract with a limited number of facilities to contain costs. For approval to participate in the program, a freestanding ASC facility must meet the following criteria:
(1) State licensure requirements. Facilities must comply with state licensure requirements for ambulatory surgical centers at §§135.1 - 135.29 of this title (relating to Operating Requirements for Ambulatory Surgical Centers).
(2) Medicare certification. Facilities must comply with Medicare standards concerning ambulatory surgical services at 42 Code of Federal Regulations, Parts 405 and 416.
(c) The program reimbursement for care at freestanding ASC facilities shall be limited to Levels I and II surgical procedures as designated by the American Society of Anesthesiologists.
Source Note: The provisions of this §351.7 adopted to be effective July 1, 2001, 26 TexReg 2979; amended to be effective June 1, 2006, 31 TexReg 4200; amended to be effective October 3, 2010, 35 TexReg 8921; amended to be effective April 21, 2013, 38 TexReg 2362; transferred effective March 15, 2022, as published in the February 25, 2022 issue of the Texas Register, 47 TexReg 982