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Certificates of Need for North Carolina Dental Ambulatory Surgery Facilities Likely to be Up for Grabs in 2016

Certificates of Need for North Carolina Dental Ambulatory Surgery Facilities Likely to be Up for Grabs in 2016

Health Care Law Note
(September 11, 2015)

On September 8, 2015, the Acute Care Services Committee of the State Health Coordinating Council (SHCC) approved a recommendation to add a need determination for four dental single specialty ambulatory surgery facilities as demonstration projects in the 2016 State Medical Facilities Plan (SMFP). The full SHCC will vote on the proposal in October.

The proposed demonstration project is in response to petitions from dental providers in Cumberland County and Wake County. Both providers described difficulties they have encountered in scheduling hospital operating rooms for dental surgeries that require the administration of general anesthesia, particularly for low-income patients. Further adding to these difficulties, general dentists and some oral surgeons are not eligible for admitting privileges in hospitals. Accordingly, both providers requested a special need determination for dental-only operating rooms in their respective counties.

The Committee recommended denying both petitions but to instead adopt a statewide Dental Single Specialty Ambulatory Surgical Facility Demonstration Project. As approved by the Committee, the Demonstration Project would establish a need determination for up to four dental single specialty ambulatory surgical facilities that would be separately licensed. A single facility with up to two operating rooms could be approved in each of four regions:

  1. Health Service Area (HSA) IV (including the Triangle);
  2. HSA III (including Mecklenburg County and surrounding areas);
  3. HSAs V and VI (including Cumberland County and surrounding areas as well as the eastern portion of the State); and
  4. HSAs I and II (including the Triad and surrounding areas as well as the western portion of the State).

Each facility will be required to meet certain criteria, including obtaining licensing and accreditation, providing a specific amount of charity care and Medicaid treatments, and performing at least 900 surgical cases per operating room by the third full federal fiscal year of operations. Of particular importance to the Committee was providing access to the medically underserved, with the Committee recommending that the required Medicaid treatments be increased from 25 percent of the facility's patient base, as originally proposed, to 30 percent.

The SHCC will vote on the proposed Demonstration Project at its October 7 meeting, but given the high level of involvement of the Committee in preparing the proposal and the interest expressed in previous SHCC meetings, it seems likely to be included in the 2016 SMFP.

Elizabeth  Sims Hedrick
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