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Outpatient Surgery E-Weekly

Contact Congress Over Drug Shortage Issues

A Kentucky congressman is urging surgical facilities to contact their members of Congress and request that they sign his letter demanding changes to...

N.J. Posts ASC Inspection Reports Online

State and federal inspection reports of New Jersey's ASCs are now available online, giving patients an opportunity to make more informed choices abo...

Are Opioids Necessary?

While it's not always practical, or even possible, to eliminate opioids from your post-op pain management regiment, reducing their use in favor of n...

Archive >  Surgical Construction 2003

10 Legal Hurdles to Clear

An overview of the legal issues affecting the ownership and operations of today's surgical facilities.

Scott Becker, CPA, JD, and Nicholas S. Harned, JD, LLM

Do you need a CON?
Twenty-seven states have blanket certificate of need (CON) laws and 10 states have CON laws that do not include ASCs, according to The Federated Ambulatory Surgery Association. Many of these same states will let physicians develop a practice office-based facility without facing the barrier or the high costs (typically ranging from $50,000 to $100,000) of obtaining a CON. In the 14 states without a CON requirement, you can develop either a surgical hospital or an ASC. Different reimbursements for different settings. In an office-based facility that is not certified as an ASC, a physician may receive a higher fee for his professional services (a site-of-service differential). This is intended to reflect the increased overhead costs of performing surgical procedures in the office setting. This enhancement is usually far less than the facility fee received by an ASC, which is usually based on either one of eight specified reimbursement levels (known as groupings) for ambulatory surgical procedures, or a discount from the ASC's charge schedule.

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