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4650.0113 FINANCIAL, UTILIZATION, AND SERVICES REPORT; OUTPATIENT SURGICAL CENTERS.

Subpart 1.

Reporting requirements.

An outpatient surgical center shall submit a report, including the financial, utilization, and services information described in subpart 4, for the outpatient surgical center's last full accounting period prior to the accounting period during which it submits the report. This period is called the reporting year. Information must be reported according to subpart 3.

Subp. 2.

Changes in accounting period.

If an outpatient surgical center changes its audited accounting period, reports must include financial, utilization, and services information for all time periods. Required information for a period of up to 13 months may be included in one report.

Subp. 3.

Estimating.

Whenever reasonably possible, an outpatient surgical center must report actual numbers in all categories. If it is not reasonably possible for the facility to report actual numbers, the facility may estimate using reasonable methods. Upon request from the commissioner, the outpatient surgical center must provide a written explanation of the method used for the estimate.

Subp. 4.

Financial, utilization, and services information.

Financial, utilization, and services information must include:

A.

the number of surgical cases;

B.

the number of operating rooms;

C.

the average weekly hours open;

D.

the type of nonsurgical procedures or services provided, including radiology, laboratory, and medical procedures and services;

E.

the average number of full-time equivalent employees by employee classification;

F.

the number of physicians with staff privileges;

G.

the ten surgical procedures performed most frequently during the reporting year, including the procedure name, the current procedural terminology code number, and the number of procedures. Current procedural terminology code numbers are contained in "Physician's Current Procedural Terminology" (CPT manual) (4th edition 1996 and subsequent editions), published by the American Medical Association. The CPT manual is incorporated by reference, is subject to frequent change, and is available through the Minitex interlibrary loan system;

H.

gross surgical center revenue from patient care;

I.

charges by type of payer;

J.

adjustments and uncollectibles by type of payer, and for charity care;

K.

bad debt and total operating expenses;

L.

total administrative expenses;

M.

an estimate of regulatory and compliance reporting expenses;

N.

management information systems expenses and plant, equipment, and occupancy expenses;

O.

a description of ownership, including corporations that the outpatient surgical center is owned by or owns;

P.

a description of contracts or formal affiliations with hospitals, providers of radiology services, providers of laboratory services, other outpatient surgical centers, or third-party payers, including the name of the entity, the purpose of the contract, and whether the contract or affiliation includes price discounts, quality or practice patterns, performance incentives, volume of business guarantees, or exclusivity arrangements;

Q.

the availability of price information, including whether:

(1)

prices are posted at the surgical center;

(2)

a written price list is available on request;

(3)

specific service prices are available on request;

(4)

prices are included in advertising and other literature; or

(5)

it is the surgical center's policy not to disclose price information;

R.

the number of inquiries concerning the price of services the surgical center receives in an average business week;

S.

a description of charity care policies, including income guidelines, asset guidelines, medical assistance status impact, and sliding fee schedules;

T.

a general description of the change in the demand for charity care to be provided in the budget year; and

U.

a general estimate of the change in the amount of charity care the surgical center expects to provide in the budget year.

Statutory Authority:

MS s 62J.321; 144.56; 144.703

History:

21 SR 1106; 26 SR 627

Published Electronically:

January 19, 2005

Official Publication of the State of Minnesota
Revisor of Statutes