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FINAL RULE: Medicare Program--Changes to the Ambulatory Surgical Centers Patient Rights Conditions for Coverage

Effective December 23, 2011

November 3, 2011

Authors: Joan W. Feldman, John H. Lawrence, Vincenzo Carannante, William J. Roberts

As one of the Conditions for Coverage under the Medicare program, Ambulatory Surgical Centers (ASCs) are required to inform the patient or their representative of the patient’s rights, and must protect and promote the exercise of such rights.  Currently, 42 C.F.R. § 416.50(a)(1) requires ASCs to provide the patient or their representative verbal or written notice of the patient’s rights in advance of the date of a surgical procedure.  The final rule revises this Condition for Coverage to allow ASCs to provide patient rights information prior to the start of the surgical procedure.

Additionally, § 416.50(a)(3) currently requires ASCs to establish grievance procedures for documenting the existence, submission, investigation and disposition of a patient’s written or verbal grievance to the ASC and to provide the grievance decision to the patient.  The final rule revises this Condition for Coverage to require that the grievance decision be given to the patient, the patient’s representative or the patient’s surrogate. These changes are effective as of December 23, 2011.

If you have any questions about this final rule, please contact one of the members of our Health Law Practice Group.

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