Masters Thesis

Should ambulatory surgery centers in California require state licensing?

For the past four years, the State of California has been divided. The California Medical Board has maintained jurisdiction over physicians for decades. Since 2007, the role of the California Medical Board has expanded to oversee physician-owned ambulatory surgery centers as well. The California Department of Public Health regulates ambulatory surgery centers with no physician ownership. Thus, California has a split in the authority pertaining to the ambulatory surgery center industry. The California Department of Public Health will license facilities under its jurisdiction. No other facilities can become state-licensed. This is a disparity in the system. The California Medical Board, on the other hand, allows accreditation of physician-owned ambulatory surgery centers. The Medical Board authorizes four different agencies with as many sets of standards to credential the physician-owned facilities. This represents another contradiction in the California system. Finally, the Centers for Medicare and Medicaid Services require certification of all ambulatory surgery centers that treat Medicare beneficiaries, with no distinction of ownership, representing yet another set of standards. Further complicating the situation, the Centers for Medicare and Medicaid Services granted specific accreditation agencies the power to deem ambulatory surgery centers meet the federal regulations for treating Medicare recipients. All agencies and stakeholders have one goal, to protect the health and safety of individuals seeking treatment in ambulatory surgery centers. The need for simplification and conformity appears obvious, as the efficiencies would add much needed value and transparency to the complex and confusing healthcare system.

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