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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