New York regulators are poised to consider a narrow but potentially consequential shift in where certain cardiac procedures can be performed.
At its Feb. 19 meeting, the New York State Public Health and Health Planning Council (PHHPC) may weigh a policy change that would allow some ambulatory surgery centers (ASCs) affiliated with general hospitals to perform percutaneous coronary interventions (PCIs), a minimally invasive procedure used to open blocked heart arteries. If approved, the state Department of Health would move to implement the change through formal rulemaking.
Under current New York law, PCIs are restricted to Article 28 general hospitals, which are defined as facilities providing 24-hour inpatient medical and surgical services with emergency care capabilities and organized medical and nursing staff. Long-standing regulations have confined the procedures to hospital settings to ensure oversight and immediate access to higher-level care in the event of complications.
Today, 78 general hospitals in New York perform roughly 52,000 PCIs annually, including 35 with on-site cardiac surgery and 43 without, according to The National Law Review, which first covered this regulatory development in a Feb. 10 update.
The proposal would take a phased approach. Initially, only Article 28 general hospitals that fully own nonprofit ASCs and maintain existing cardiac surgery programs would qualify.
Eligible ASCs would be required to use their parent hospital’s quality review and data reporting systems. Projects would undergo a time-limited Certificate of Need (CON) process, including a Health Equity Impact Assessment and assurances of access for Medicaid and low-income patients.
In many ways, New York’s current stance goes against national trends.
“At the national level, most states allow the performance of PCIs in ASCs with approximately 20 of these states reporting detailed data which indicate that the complication rate in ASCs essentially matches those performed in hospitals at just [1%],” PHHPC shared in a related report.
Data from those states show complication rates comparable to hospitals, at about 1%, while costs are roughly 40% lower – or about $4,000 in savings per procedure.
State officials have indicated the policy could later expand to additional ASCs, including independent centers, depending on clinical outcomes, access metrics and equity data collected during the initial phase.
