Surgical and radiologic procedures performed in freestanding surgical centers, physicians??? offices and urgent care settings in New York would be subject to a 9.63 percent tax under New York Gov. David Paterson???s proposed 2009-10 executive budget.

"This proposal is an attempt to level the playing field between hospitals and these other care settings," says Matt Anderson, spokesperson for New York state budget division. "Our aim with this initiative is to take away a competitive advantage."

The state???s ASCs currently pay a 8.95 percent surcharge on every procedure they perform, says Margaret Alteri, CASC, the president of the New York State Association of Ambulatory Surgery Centers, so the governor???s budget bill would make a high surcharge higher and extend the tax to office-based surgery and urgent care.

"We would still oppose it," says Ms. Alteri. "We are working with other groups in the state who are affected by this proposal, as the language in the budget proposal is quite vague. Until we know the full extent of this proposal on our members, we will be watching this issue very closely. The ASC Association is assisting and supporting us in our efforts."

This proposal would require insurers to pay the Department of Health the 9.63 percent surcharge on all payments made for surgery or radiology services provided outside of the hospital setting. Ms. Alteri says the tax would erode the contracted rates insurers pay surgical facilities.

"Third-party payors submit payment to the health department and we collect it on co-insurance and have to file a monthly report with the state about what we collected," says Ms. Alteri.

—Dan O???Connor