Project 396

FSASC is excited to announce Project 396 - a new legislative initiative for 2025 that seeks to address the historic imbalance between Hospitals and ASCs. Since 1978, ASCs have been included in the Hospital licensure statute (Florida Statute 395 or “F.S. 395”). While inclusion made sense in the 1970s, the ASC industry has drastically changed in the intervening 50 years with ASCs becoming the leading low-cost option for elective surgical care in Florida. Thus, it is time that ASCs were granted their own licensure statute.

Accordingly, FSASC has partnered with Representative Tiffany Esposito of Florida’s 77th District and with Senator Jay Trumbull of the 2nd District to introduce HB 475 and SB 1370 which grant ASCs their own licensure statute (tentatively designated as Florida Statute 396). If passed, these Bills would secure equal dignity for ASCs with Hospitals by granting ASCs their own provisions tailored for ASCs. As drafted, these Bills do not make major changes to ASCs’ current licensure framework; however, FSASC expects that separate licensure will result in major benefits to Florida’s ASC industry by 1) eliminating regulatory confusion; 2) reducing ASCs’ financial burdens; and 3) empowering the Legislature to create unique provisions for the benefit of Florida ASCs.

There are several instances across F.S. 395 where the law is clearly written to govern Hospitals yet is applied to ASCs arbitrarily. This creates confusion about which rules apply to ASCs and which do not. For example, F.S. 395’s standards for licensure, fees, and inspection costs are based on how many “Hospital Beds” a facility has. However, by definition, ASCs have no Hospital Beds. While this provision has been interpreted to ignore the word “Hospital” when applied to ASCs, this amounts to violating the letter of the law to preserve the spirit. Florida ASCs deserve better than a workaround.

As a result of ASCs’ historic treatment as an afterthought, many of the penalties and fees assessed in F.S. 395 are scaled to the size and resources of Hospitals – not to small businesses like ASCs. Project 396 intends to rectify this disparity by creating space for Legislators to reduce ASCs’ burdens without affecting existing rules against Hospitals. This will allow smaller ASCs to fairly compete with larger Hospitals who receive state assistance and can better afford large penalties and other administrative burdens.

FSASC has been advocating for ASCs’ interests with the Florida Legislature for over 30 years. During this time, one of the most common refrains that we have heard is resistance to change major initiatives for and against Hospitals because of incidental impacts to ASCs. Legislators often need a primer on the ways that ASCs differ from Hospitals – from our separate profitability models to our inherent culture of price transparency. As such, the Legislature can struggle to appreciate how major legislative initiatives have serious and unintended consequents for ASCs – consequences that can be far removed from the original purpose of the legislation. Accordingly, by creating a separate statute for ASCs, Legislators will be better equipped to draft tailored legislation to the benefit of the ASC Industry – and to insulate the industry from unintentional harm.

While FSASC believes that Project 396 will pay dividends to the Florida ASC Industry for years to come, we cannot get this legislation passed alone. We are calling on you, our members, to get involved with Project 396 for the benefit of all ASCs. We encourage you to contact Representative Esposito (239.445.0150; [email protected]) and Senator Trumbull (850.487.5002; [email protected]), thank them for their sponsorship, and share some of your frustrations.

We would also like to hear from you directly about the challenges that you have encountered due to ASCs being included in the Hospital Licensure statute and your thoughts and suggestions for future ways that ASC regulation could be better tailored to the specific needs and issues of the Florida ASC industry. Please contact [email protected] to share your thoughts with us, and we look forward to seeing you in person at FSASC’s upcoming  Quality and Risk Management Conference April 10 – 11, 2025.