MISSISSIPPI LEGISLATURE REGULAR SESSION 2017 By ...

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AN ACT TO AMEND SECTIONS 41-75-1, 41-75-3, 41-75-5 AND. 1. 41-75-13, MISSISSIPPI CODE OF 1972, TO DEFINE "POST-ACUTE. 2.
MISSISSIPPI LEGISLATURE

REGULAR SESSION 2017

By:

To: Public Health and Human Services

Representatives Mims, Dixon, Corley

COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 478

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AN ACT TO AMEND SECTIONS 41-75-1, 41-75-3, 41-75-5 AND 41-75-13, MISSISSIPPI CODE OF 1972, TO DEFINE "POST-ACUTE RESIDENTIAL BRAIN INJURY REHABILITATION FACILITY" FOR THE PURPOSE OF LICENSURE BY THE STATE DEPARTMENT OF HEALTH; TO REQUIRE A LICENSE TO OPERATE AND PROVIDE PROCEDURES FOR APPLICATION; TO PROHIBIT POST-ACUTE RESIDENTIAL BRAIN INJURY REHABILITATION FACILITIES FROM PARTICIPATING IN THE MEDICAID PROGRAM; AND FOR RELATED PURPOSES. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

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SECTION 1.

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amended as follows:

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41-75-1.

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(a)

Section 41-75-1, Mississippi Code of 1972, is

For the purpose of this chapter: "Ambulatory surgical facility" means a publicly or

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privately owned institution that is primarily organized,

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constructed, renovated or otherwise established for the purpose of

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providing elective surgical treatment of "outpatients" whose

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recovery, under normal and routine circumstances, will not require

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"inpatient" care.

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include the offices of private physicians or dentists, whether

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practicing individually or in groups, but does include

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organizations or facilities primarily engaged in that outpatient H. B. No. 478 17/HR31/R1441CS PAGE 1 (RF\JAB)

The facility defined in this paragraph does not

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surgery, whether using the name "ambulatory surgical facility" or

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a similar or different name.

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any manner considered to be operated or owned by a hospital or a

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hospital holding, leasing or management company, either for profit

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or not for profit, is required to comply with all licensing agency

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ambulatory surgical licensure standards governing a "hospital

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affiliated" facility as adopted under Section 41-9-1 et seq.,

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provided that the organization or facility does not intend to seek

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federal certification as an ambulatory surgical facility as

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provided for at 42 CFR, Parts 405 and 416.

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facility is to be operated or owned by a hospital or a hospital

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holding, leasing or management company and intends to seek federal

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certification as an ambulatory facility, then the facility is

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considered to be "freestanding" and must comply with all licensing

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agency ambulatory surgical licensure standards governing a

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"freestanding" facility.

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That organization or facility, if in

If the organization or

If the organization or facility is to be owned or operated by

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an entity or person other than a hospital or hospital holding,

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leasing or management company, then the organization or facility

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must comply with all licensing agency ambulatory surgical facility

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standards governing a "freestanding" facility.

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(b)

"Hospital affiliated" ambulatory surgical facility

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means a separate and distinct organized unit of a hospital or a

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building owned, leased, rented or utilized by a hospital and

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located in the same county in which the hospital is located, for H. B. No. 478 17/HR31/R1441CS PAGE 2 (RF\JAB)

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the primary purpose of performing ambulatory surgery procedures.

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The facility is not required to be separately licensed under this

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chapter and may operate under the hospital's license in compliance

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with all applicable requirements of Section 41-9-1 et seq.

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(c)

"Freestanding" ambulatory surgical facility means a

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separate and distinct facility or a separate and distinct

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organized unit of a hospital owned, leased, rented or utilized by

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a hospital or other persons for the primary purpose of performing

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ambulatory surgery procedures.

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licensed as defined in this section and must comply with all

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licensing standards promulgated by the licensing agency under this

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chapter regarding a "freestanding" ambulatory surgical facility.

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Further, the facility must be a separate, identifiable entity and

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must be physically, administratively and financially independent

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and distinct from other operations of any other health facility,

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and shall maintain a separate organized medical and administrative

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staff.

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surgical facility, the facility shall not become a component of

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any other health facility without securing a certificate of need

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to do that.

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The facility must be separately

Furthermore, once licensed as a "freestanding" ambulatory

(d)

"Ambulatory surgery" means surgical procedures that

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are more complex than office procedures performed under local

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anesthesia, but less complex than major procedures requiring

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prolonged postoperative monitoring and hospital care to ensure

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safe recovery and desirable results. H. B. No. 478 17/HR31/R1441CS PAGE 3 (RF\JAB)

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in most cases.

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to be discharged on the same day.

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be performed by physicians or dentists licensed to practice in the

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State of Mississippi.

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(e)

The patient must arrive at the facility and expect Ambulatory surgery shall only

"Abortion" means the use or prescription of any

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instrument, medicine, drug or any other substances or device to

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terminate the pregnancy of a woman known to be pregnant with an

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intention other than to increase the probability of a live birth,

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to preserve the life or health of the child after live birth or to

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remove a dead fetus.

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trimester shall only be performed at a Level I abortion facility

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or an ambulatory surgical facility or hospital licensed to perform

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that service.

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(f)

Abortion procedures after the first

"Abortion facility" means a facility operating

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substantially for the purpose of performing abortions and is a

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separate identifiable legal entity from any other health care

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facility.

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licensed to practice in the State of Mississippi.

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associated with the abortion facility must have admitting

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privileges at a local hospital and staff privileges to replace

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local hospital on-staff physicians.

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with an abortion facility must be board certified or eligible in

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obstetrics and gynecology, and a staff member trained in CPR shall

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always be present at the abortion facility when it is open.

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term "abortion facility" includes physicians' offices that are

Abortions shall only be performed by physicians

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All physicians

All physicians associated

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The

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used substantially for the purpose of performing abortions.

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abortion facility operates substantially for the purpose of

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performing abortions if any of the following conditions are met:

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(i)

An

The abortion facility is a provider for

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performing ten (10) or more abortion procedures per calendar month

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during any month of a calendar year, or one hundred (100) or more

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in a calendar year.

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(ii)

The abortion facility, if operating less than

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twenty (20) days per calendar month, is a provider for performing

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ten (10) or more abortion procedures, or performing a number of

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abortion procedures that would be equivalent to ten (10)

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procedures per month, if the facility were operating twenty (20)

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or more days per calendar month, in any month of a calendar year.

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(iii)

The abortion facility holds itself out to

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the public as an abortion provider by advertising by any public

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means, such as newspaper, telephone directory, magazine or

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electronic media, that it performs abortions.

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(iv)

for licensure as an abortion facility.

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The facility applies to the licensing agency

(g)

"Licensing agency" means the State Department of

(h)

"Operating" an abortion facility means that the

Health.

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facility is open for any period of time during a day and has on

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site at the facility or on call a physician licensed to practice

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in the State of Mississippi available to provide abortions. H. B. No. 478 17/HR31/R1441CS PAGE 5 (RF\JAB)

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An abortion facility may apply to be licensed as a Level I

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facility or a Level II facility by the licensing agency.

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abortion facilities shall be required to meet minimum standards

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for abortion facilities as established by the licensing agency.

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Level I abortion facilities shall be required to meet minimum

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standards for abortion facilities and minimum standards for

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ambulatory surgical facilities as established by the licensing

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agency.

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Level II

Any abortion facility that begins operation after June 30,

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1996, shall not be located within one thousand five hundred

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(1,500) feet from the property on which any church, school or

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kindergarten is located.

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violation of this paragraph if it is in compliance with this

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paragraph on the date it begins operation and the property on

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which a church, school or kindergarten is located within one

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thousand five hundred (1,500) feet from the facility.

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(i)

An abortion facility shall not be in

"Freestanding emergency room" is a facility open

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twenty-four (24) hours a day for the treatment of urgent and

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emergent medical conditions which is not located on a hospital

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campus.

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the freestanding emergency room shall be located at least fifteen

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(15) miles from the nearest hospital-based emergency room in any

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rural community where the federal CMMS had previously designated a

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rural hospital as a critical access hospital and that designation

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has been revoked.

In order to be eligible for licensure under this chapter,

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(j)

"Post-acute residential brain injury rehabilitation

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facility" is a facility containing no more than twelve (12) beds

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providing medically directed long-term but nonacute rehabilitation

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to patients who have acquired brain injury.

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eligible for licensure under this chapter, the post-acute

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residential brain injury rehabilitation facility shall be located

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at least twenty-five (25) miles from the nearest acute care

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rehabilitation hospital and at least five (5) miles from the

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boundaries of any municipality having a population of ten thousand

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(10,000) or more, according to the most recent federal decennial

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census, at the time that facility is established.

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SECTION 2.

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amended as follows:

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41-75-3.

In order to be

Section 41-75-3, Mississippi Code of 1972, is

The purpose of this chapter is to protect and

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promote the public welfare by providing for the development,

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establishment and enforcement of certain standards in the

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maintenance and operation of ambulatory surgical facilities and

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abortion facilities and freestanding emergency rooms and

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post-acute residential brain injury rehabilitation facilities,

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which will ensure safe, sanitary, and reasonably adequate care of

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individuals in such facilities.

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SECTION 3.

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amended as follows:

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41-75-5.

Section 41-75-5, Mississippi Code of 1972, is

No person as defined in Section 41-7-173, * * *

acting severally or jointly with any other person, shall H. B. No. 478 17/HR31/R1441CS PAGE 7 (RF\JAB)

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establish, conduct, operate or maintain an ambulatory surgical

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facility or an abortion facility or a freestanding emergency room

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or a post-acute residential brain injury rehabilitation facility

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in this state without a license under this chapter.

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In order to receive a license for a post-acute residential

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brain injury rehabilitation facility under this chapter, the

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recipient of the license must agree in writing that the facility

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will not at any time participate in the Medicaid program (Section

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43-13-101 et seq.) or admit or keep any patients in the facility

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who are participating in the Medicaid program.

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agreement by the recipient of the license shall be fully binding

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on any later owner of the facility, if the ownership of the

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facility is transferred at any time after the issuance of the

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license.

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Medicaid program shall be a condition of the issuance of a license

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for a post-acute residential brain injury rehabilitation facility

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to any person under this chapter, and if such facility at any time

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after the issuance of the license, regardless of the ownership of

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the facility, participates in the Medicaid program or admits or

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keeps any patients in the facility who are participating in the

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Medicaid program, the licensing agency shall revoke the license of

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the facility, at the time that the department determines, after a

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hearing complying with due process, that the facility has failed

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to comply with any of the conditions upon which the license was

This written

Agreement that the facility will not participate in the

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issued, as provided in this section and in the written agreement

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by the recipient of the license.

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SECTION 4.

Section 41-75-13, Mississippi Code of 1972, is

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amended as follows:

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41-75-13.

The licensing agency shall adopt, amend,

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promulgate and enforce rules, regulations and standards, including

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classifications, with respect to ambulatory surgical facilities

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and abortion facilities, * * * freestanding emergency rooms and

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post-acute residential brain injury rehabilitation facilities

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licensed, or which may be licensed, to further the accomplishment

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of the purpose of this chapter in protecting and promoting the

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health, safety and welfare of the public by ensuring adequate care

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of individuals receiving services from such facilities.

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licensing agency also shall adopt, amend, promulgate and enforce

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rules, regulations and standards with respect to the enforcement

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of the informed consent requirements of Sections 41-41-31 through

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41-41-39 at abortion facilities.

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standards for freestanding emergency rooms shall include a patient

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transfer policy under which the freestanding emergency room enters

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into an agreement with a general hospital for a protocol for

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patient transfers.

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adopted and promulgated by the licensing agency in accordance with

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the provisions of Section 25-43-1 et seq., and shall be recorded

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and indexed in a book to be maintained by the licensing agency in

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its main office in the State of Mississippi, entitled "Rules and H. B. No. 478 17/HR31/R1441CS PAGE 9 (RF\JAB)

The

Such rules, regulations and

Such rules, regulations and standards shall be

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Regulations for Operation of Ambulatory Surgical Facilities and

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Abortion Facilities * * *, Freestanding Emergency Room Facilities

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and Post-Acute Residential Brain Injury Rehabilitation

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Facilities."

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ambulatory surgical facilities and abortion facilities * * *,

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freestanding emergency rooms and post-acute residential brain

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injury rehabilitation facilities and the public during regular

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business hours.

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SECTION 5.

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The book shall be open and available to all

This act shall take effect and be in force from

and after July 1, 2017.

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