Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-6 - Health Partnership Program › Section 4123-6-02.22 - Provider access to the HPP - ambulatory surgical center arthroplasty center requirements

Current through all regulations passed and filed through July 1, 2024
(A) To be eligible for participation in the
			 HPP as an ambulatory surgical center arthroplasty center, an ambulatory
			 surgical center must :
(1)
									Be certified as an ambulatory surgical center under
			 paragraph (C) of rule
			 4123-6-02.2 of the
			 Administrative Code.
(2)
									Have a formal joint replacement program which has been
			 in place for at least one year prior to the date of application, and
			  have performed a minimum of ten
			 arthroplasty procedures prior to the date of application.
(3)
									Have a physician credentialing
			 criteria policy which includes, at a minimum:
(a) A statement confirming any surgeon
			 performing the service for injured workers is board certified in a related
			 surgery specialty;
(b) A statement
			 confirming any surgeon performing this service for injured workers has
			 performed the procedure at the facility within one year prior to the date of
			 application;
(c) A statement
			 confirming any surgeon performing the service for injured workers has admitting
			 privileges at a hospital within thirty miles of the facility or otherwise
			 closest hospital;
(d) The facility
			 recredentials surgeons at regular intervals.
(4)
									Have a patient selection
			 criteria policy for injured workers consistent
			 with applicable standards of care which includes, at a minimum:
(a) The patient is American society of
			 anesthesiologists (ASA) physical status I (normal healthy patient) or II
			 (patients with mild systemic disease);
(b) The patient is under sixty-five years of
			 age;
(c) The patient has a body
			 mass index which is not likely to affect surgical outcome;
(d) The patient has no co-morbid conditions
			 that would be likely to affect surgical outcome;
(e) The patient has one or more individuals
			 to assist with immediate post- surgical recovery care (home support).
(5)
									Report quality data
			 measures to the centers for medicare and medicaid services (CMS) under the
			 ambulatory surgical center quality reporting (ASCQR) program.
(6)
									Have an established protocol
			 for tracking and reporting the following Ohio association of ambulatory surgery
			 center (OAASC) quality data measures:
(a)
			 Number of extended stays past midnight;
(b) Number of unexpected complications;
(i) Vomiting which does not respond to
			 treatment;
(ii) Severe pain not
			 responding to treatment;
(iii)
			 Excessive bleeding 
											necessitating a return to surgery or
			 transfer;
(iv) Cardiac or
			 respiratory arrest;
(c)
			 Number of other incidents in the following areas:
(i) Medication errors;
(ii) Medical device errors;
(iii) Unintentional retained foreign
			 body;
(d) Post discharge
			 complications;
(i) Infections (thirty days
			 post-operative; implants up to one year);
(ii) Emergency room visit within forty-eight
			 hours for related issue;
(7)
									List on its application the
			 specific procedure(s) it is requesting bureau certification to perform and
			 receive reimbursement for under rule
			 4123-6-37.3 of the
			 Administrative Code as an ambulatory surgical center arthroplasty
			 center.