1.1 	A bill for an act
1.2 	relating to health; authorizing an additional hospital
1.3 	accrediting organization for presumptive licensure
1.4 	purposes; amending Minnesota Statutes 2004, sections
1.5 	144.122; 144.55, subdivisions 2, 4, 5.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. Minnesota Statutes 2004, section 144.122, is
1.8 	amended to read:
1.9 	144.122 LICENSE, PERMIT, AND SURVEY FEES.
1.10 	(a) The state commissioner of health, by rule, may
1.11 	prescribe reasonable procedures and fees for filing with the
1.12 	commissioner as prescribed by statute and for the issuance of
1.13 	original and renewal permits, licenses, registrations, and
1.14 	certifications issued under authority of the commissioner.  The
1.15 	expiration dates of the various licenses, permits,
1.16 	registrations, and certifications as prescribed by the rules
1.17 	shall be plainly marked thereon.  Fees may include application
1.18 	and examination fees and a penalty fee for renewal applications
1.19 	submitted after the expiration date of the previously issued
1.20 	permit, license, registration, and certification.  The
1.21 	commissioner may also prescribe, by rule, reduced fees for
1.22 	permits, licenses, registrations, and certifications when the
1.23 	application therefor is submitted during the last three months
1.24 	of the permit, license, registration, or certification period.
1.25 	Fees proposed to be prescribed in the rules shall be first
2.1 	approved by the Department of Finance.  All fees proposed to be
2.2 	prescribed in rules shall be reasonable.  The fees shall be in
2.3 	an amount so that the total fees collected by the commissioner
2.4 	will, where practical, approximate the cost to the commissioner
2.5 	in administering the program.  All fees collected shall be
2.6 	deposited in the state treasury and credited to the state
2.7 	government special revenue fund unless otherwise specifically
2.8 	appropriated by law for specific purposes.
2.9 	(b) The commissioner may charge a fee for voluntary
2.10 	certification of medical laboratories and environmental
2.11 	laboratories, and for environmental and medical laboratory
2.12 	services provided by the department, without complying with
2.13 	paragraph (a) or chapter 14.  Fees charged for environment and
2.14 	medical laboratory services provided by the department must be
2.15 	approximately equal to the costs of providing the services.
2.16 	(c) The commissioner may develop a schedule of fees for
2.17 	diagnostic evaluations conducted at clinics held by the services
2.18 	for children with handicaps program.  All receipts generated by
2.19 	the program are annually appropriated to the commissioner for
2.20 	use in the maternal and child health program.
2.21 	(d) The commissioner shall set license fees for hospitals
2.22 	and nursing homes that are not boarding care homes at the
2.23 	following levels:
2.24 	Joint Commission on Accreditation of Healthcare
2.25 	Organizations (JCAHO hospitals )
2.26 	and American Osteopathic 
2.27 	Association (AOA) hospitals $7,055
2.28 	Non-JCAHO and non-AOA hospitals  $4,680 plus $234 per bed
2.29 	Nursing home                     $183 plus $91 per bed
2.30 	The commissioner shall set license fees for outpatient
2.31 	surgical centers, boarding care homes, and supervised living
2.32 	facilities at the following levels:
2.33 	Outpatient surgical centers      $1,512
2.34 	Boarding care homes              $183 plus $91 per bed
2.35 	Supervised living facilities     $183 plus $91 per bed.
2.36 	(e) Unless prohibited by federal law, the commissioner of
3.1 	health shall charge applicants the following fees to cover the
3.2 	cost of any initial certification surveys required to determine
3.3 	a provider's eligibility to participate in the Medicare or
3.4 	Medicaid program:
3.5 	Prospective payment surveys for          $  900
3.6 	hospitals
3.8 	Swing bed surveys for nursing homes      $1,200
3.10 	Psychiatric hospitals                    $1,400
3.12 	Rural health facilities                  $1,100
3.14 	Portable x-ray providers                 $  500
3.16 	Home health agencies                     $1,800
3.18 	Outpatient therapy agencies              $  800
3.20 	End stage renal dialysis providers       $2,100
3.22 	Independent therapists                   $  800
3.24 	Comprehensive rehabilitation             $1,200
3.25 	outpatient facilities
3.27 	Hospice providers                        $1,700
3.29 	Ambulatory surgical providers            $1,800
3.31 	Hospitals                                $4,200
3.33 	Other provider categories or             Actual surveyor costs:
3.34 	additional resurveys required            average surveyor cost x
3.35 	to complete initial certification        number of hours for the
3.36 	                                         survey process.
3.37 	These fees shall be submitted at the time of the
3.38 	application for federal certification and shall not be
3.39 	refunded.  All fees collected after the date that the imposition
3.40 	of fees is not prohibited by federal law shall be deposited in
3.41 	the state treasury and credited to the state government special
3.42 	revenue fund.

3.43 	Sec. 2. Minnesota Statutes 2004, section 144.55,
3.44 	subdivision 2, is amended to read:
3.45 		Subd. 2.Definitions.  For the purposes of this section,
3.46 	the following terms have the meanings given:
3.47 	(a) "Outpatient surgical center" or "center" means a
3.48 	freestanding facility organized for the specific purpose of
3.49 	providing elective outpatient surgery for preexamined,
3.50 	prediagnosed, low-risk patients.  Admissions are limited to
3.51 	procedures that utilize general anesthesia or conscious sedation
4.1 	and that do not require overnight inpatient care.  An outpatient
4.2 	surgical center is not organized to provide regular emergency
4.3 	medical services and does not include a physician's or dentist's
4.4 	office or clinic for the practice of medicine, the practice of
4.5 	dentistry, or the delivery of primary care.
4.6 	(b) "Joint commission" "Approved accrediting organization" 
4.7 	means the Joint Commission on Accreditation of Health Care
4.8 	Organizations or the American Osteopathic Association.

4.9 	Sec. 3. Minnesota Statutes 2004, section 144.55,
4.10 	subdivision 4, is amended to read:
4.11 		Subd. 4.Routine inspections; presumption.  Any hospital
4.12 	surveyed and accredited under the standards of the hospital
4.13 	accreditation program of the joint commission an approved
4.14 	accrediting organization that submits to the commissioner within
4.15 	a reasonable time copies of (a) its currently valid
4.16 	accreditation certificate and accreditation letter, together
4.17 	with accompanying recommendations and comments and (b) any
4.18 	further recommendations, progress reports and correspondence
4.19 	directly related to the accreditation is presumed to comply with
4.20 	application requirements of subdivision 1 and the standards
4.21 	requirements of subdivision 3 and no further routine inspections
4.22 	or accreditation information shall be required by the
4.23 	commissioner to determine compliance.  Notwithstanding the
4.24 	provisions of sections 144.54 and 144.653, subdivisions 2 and 4,
4.25 	hospitals shall be inspected only as provided in this section.
4.26 	The provisions of section 144.653 relating to the assessment and
4.27 	collection of fines shall not apply to any hospital.  The
4.28 	commissioner of health shall annually conduct, with notice,
4.29 	validation inspections of a selected sample of the number of
4.30 	hospitals accredited by the joint commission an approved
4.31 	accrediting organization, not to exceed ten percent of
4.32 	accredited hospitals, for the purpose of determining compliance
4.33 	with the provisions of subdivision 3.  If a validation survey
4.34 	discloses a failure to comply with subdivision 3, the provisions
4.35 	of section 144.653 relating to correction orders, reinspections,
4.36 	and notices of noncompliance shall apply.  The commissioner
5.1 	shall also conduct any inspection necessary to determine whether
5.2 	hospital construction, addition, or remodeling projects comply
5.3 	with standards for construction promulgated in rules pursuant to
5.4 	subdivision 3.  Pursuant to section 144.653, the commissioner
5.5 	shall inspect any hospital that does not have a currently valid
5.6 	hospital accreditation certificate from the joint commission an
5.7 	approved accrediting organization.  Nothing in this subdivision
5.8 	shall be construed to limit the investigative powers of the
5.9 	Office of Health Facility Complaints as established in sections
5.10 	144A.51 to 144A.54.

5.11 	Sec. 4. Minnesota Statutes 2004, section 144.55,
5.12 	subdivision 5, is amended to read:
5.13 		Subd. 5.Coordination of inspections.  Prior to
5.14 	conducting routine inspections of hospitals and outpatient
5.15 	surgical centers, a state agency shall notify the commissioner
5.16 	of its intention to inspect.  The commissioner shall then
5.17 	determine whether the inspection is necessary in light of any
5.18 	previous inspections conducted by the commissioner, any other
5.19 	state agency, or the joint commission an approved accrediting
5.20 	organization.  The commissioner shall notify the agency of the
5.21 	determination and may authorize the agency to conduct the
5.22 	inspection.  No state agency may routinely inspect any hospital
5.23 	without the authorization of the commissioner.  The commissioner
5.24 	shall coordinate, insofar as is possible, routine inspections
5.25 	conducted by state agencies, so as to minimize the number of
5.26 	inspections to which hospitals are subject.