Minimum Workload Requirements

(A) Each approved cardiac catheterization service shall maintain a minimum annual caseload volume in accordance with Department guidelines, based on guidelines and standards issued by American College of Cardiology, American Heart Association and Society for Cardiac Angiography and Interventions. (1) Any cardiac catheterization service providing fewer than the specified number of procedures per year shall, within 30 days of the end of the Department’s fiscal year reporting period, submit to the Department a copy of the previous year’s Quality Assessment and Performance Improvement (QAPI) quarterly reports required under 105 CMR 130.965(E). (2) In addition to the requirements of 105 CMR 130.935(A)(1), any cardiac catheterization service providing fewer than the specified number of procedures per year shall, within 30 days of the end of the Department’s fiscal year reporting period, request a review of the catheterization service by an appropriately qualified professional peer review organization or individual(s) approved by the Department. Any physician conducting the peer review shall certify that he or she does not have any conflict of interest regarding the hospital and physicians to be reviewed. The results of the review shall be submitted to the Department within ten days of receipt. (3) Based on a review of the QAPI reports and, if applicable, the results of the assessment of the quality of the cardiac catheterization service by an appropriately qualified peer review organization or individual(s) approved by the Department, the Department shall determine whether a facility will continue to be approved to provide the service and, if applicable, subject to any conditions determined to be appropriate. (4) New services shall reach the minimum specified number of procedures within 24 months of approval of the service. (B) If a hospital is required to submit its quarterly reports of the QAPI under 105 CMR 130.935, the hospital shall subsequently continue to submit the quarterly reports of the QAPI to the Department for review each quarter until the hospital receives a notice from the Department to discontinue submission of the reports.