Ambulatory Surgery Center Definition
Ambulatory surgery centers (called outpatient surgical centers in Arizona) are defined as a class of health care institution that has the facility, staffing and equipment to provide surgery and anesthesia services to a patient whose recovery, in the opinions of the patient's surgeon and an anesthesiologist if one is providing services to the patient, does not require inpatient care in a hospital.
Private offices and clinics of health care providers licensed under title 32 that are not freestanding urgent care centers are exempt from the health care institution licensure requirement, unless:
- Patients are kept overnight as bed patients or treated otherwise under general anesthesia except when treatment by general anesthesia is regulated by title 32, chapter 11
- Or the office or clinic is an abortion clinic.
License Requirements
A person shall not establish, conduct or maintain in this state a health care institution or any class or subclass of health care institution unless that person holds a current and valid license issued by the department specifying the class or subclass of health care institution the person is establishing, conducting or maintaining.
A fee of $50 is imposed for initial licensure, licensure renewal and change of ownership (CHOW) applications.
A health care institution operating without a valid license, or operating beyond the range of services authorized by its license, is declared a nuisance inimical to public health and safety. The attorney general is empowered to bring an injunction. Anyone operating without a license is guilty of a class 3 misdemeanor. Civil penalties may also be assessed for violations.
Certificate of Need
Arizona does not have a CON program.
Length of Stay Restriction
A medical staff member shall only admit patients to the ASC who do not required planned inpatient care and are discharged from the outpatient surgical center within 24 hours.
Medical History and Physical Examination
Within 30 calendar days before a patient is admitted to an outpatient surgical center, a medical staff member shall complete a medical history and physical examination of the patient.
Transfer Agreement
Arizona does not impose a written transfer agreement requirement on ASCs. An ASC administrator shall ensure that policies and procedures for providing medical emergency treatment to a patient are established, documented and implemented and include…a method for ensuring a patient may be transferred to a hospital or other health care institution to receive treatment for a medical emergency that the outpatient surgical facility is not authorized or not able to provide.
Price Transparency
Arizona imposes price transparency requirements on the most common codes performed by a health care facility.
A health care facility (defined to include outpatient surgical centers) with 50 or fewer inpatient beds must make available on request or online the direct pay price for at least the 35 most used diagnosis-related group codes, if applicable, for the health care facility and at least the 35 most used outpatient service codes, if applicable, for the health care facility. The services may be identified by a common procedural terminology code or by a plain-English description. The health care facility must update the direct pay prices at least annually based on the services from a twelve-month period that occurred within the eighteen-month period preceding the annual update. The direct pay price must be for the standard treatment provided for the service and may include the cost of treatment for complications or exceptional treatment.
“Direct pay price” means the entire price that will be charged by a health care facility for a lawful health care service, regardless of the health insurance status of the person, if the entire fee for the service is paid in full directly to a health care facility by the person, including the person's health savings account, or by the person's employer and that does not prohibit a health care facility from establishing a payment plan with the person paying directly for services.
“Lawful health care services” means any health-related service or treatment, to the extent that the service or treatment is allowed or not prohibited by law or regulation, that may be provided by persons or businesses that are otherwise allowed to offer the services or treatments.
Workers' Compensation
Arizona's Physicians' and Pharmaceutical Fee Schedules are available here.
Patient Safety Reporting Requirements
Arizona does not impose patient safety reporting requirements on ASCs.
Charity Care
Arizona does not impose charity care requirements on ASCs.
Surgical Smoke
ASCs are required to adopt and implement policies to prevent exposure to surgical smoke by using a smoke evacuation system for each procedure that generates surgical smoke.
Advance Directives
Life Care Planning
For Full Act § 36-3201 to 36-3281
Life Care Planning Packet Materials.
State Regulator
Arizona Department of Health Services
Division of Licensing Services
150 N 18th Ave, 4th Floor
Phoenix, AZ 85007
Odette Colburn, Bureau Chief, Medical Facilities Licensing
odette.colburn@azdhs.gov
602.364.2841
Statutory & Regulatory References
Arizona Statutes: ARS § 36-401 to ARS § 36-450.02
Arizona Administrative Code: AAC R-9-10-901 to AAC R-9-10-918