I. NYS LEGISLATION TO REQUIRE ACCREDITATION OF OFFICES PERFORMING OFFICE BASED SURGERY PASSED BY BOTH HOUSES OF THE LEGISLATURE
Legislation (S. 6052(Hannon)/A.7948 (Gottfried) will require physicians who perform office-based surgery in their offices to obtain accreditation of such office setting was passed by both Houses of the Legislature. This measure is the culmination of the work of the Department of Health's Committee on Quality Assurance in Office-Based Surgery.
II. DATES
January 18, 2008 - Adverse Reporting
July 18, 2009 - Accreditation Required
Bonanno & Bonanno long expected the passage of the legislation requiring quality and safety standards to be followed by medical groups performing procedures in their surgical unit not certified under Article 28. Procedures satisfy the anesthesia requirement of greater than moderate or conscious sedation are subject to this new legislation. For example, this will require most GI groups performing office-based endoscopy to obtain accreditation through one of the NYS approved agencies. Bonanno & Bonanno has established a strategic partnership with the most reputable accreditation-consulting firm. There are companies who are advertising fast track accreditation with the anticipation of obtaining a billing relationship with your group. A buyer-be-aware approach should be taken with these firms. There is no such thing as a fast-track program as a significant investment of time will be required to prepare your practice for accreditation. Start this process by completing a well-defined due diligence and choosing an accreditation consultant who will help you through site assessment, accreditation preparation and will equipped you with the tools to conduct ongoing compliance monitoring. Ask Bonanno & Bonanno how we can assist your practice in obtaining this mission critical credential.
III. NEW YORK STATE ACCREDITATION AND CHANGE IN PRACTICE CULTURE
Many of the processes you are currently using must be codified into written P&P and ongoing review on the managerial and committee levels. Incorporating provider credentialing and ongoing peer review will be required.The health and safety codes specific to the community in which you operate will be the standards applicable to the design of facility. Accreditation will be received as a positive patient-centered program. Obtaining this status will position the practice to negotiate enhanced fees for office-based work. A new culture of measuring and reporting clinical outcomes and maintaining the quality standards your patients and health plan partners expect will be required.
IV. FINANCIAL STRUCTURE & REIMBURSEMENT
There has been a lot of discussion on whether accreditation will permit the separate negotiation of a facility fee. Accreditation is a clinical/quality requirement and, once obtained may leverage to better reimbursement. I say this because health plans through their accreditation agent, the National Committee of Quality Assurance, requires it. Health plans also want practices to offer cost effective services. Strategies and legal structure are limited to those acceptable per statute and the payment policies of health plans.That said, it is necessary to inculcate a strategy consistent with the financial objectives of the group. Bonanno & Bonanno will provide guidance; prepare a negotiation strategy with private sector plans while you prepare your practice for accreditation. Building such an integrated model is imperative to ensure longer-term goals are obtained.
