Ambulatory Surgery Centers Law, Regulation, and Operations
2026 Edition | John Fisher, Health Law Attorney
Ambulatory Surgery Centers Law and Regulation. The ambulatory surgery center law industry has become one of the most dynamic and legally demanding sectors in American healthcare. With more than 6,000 Medicare-certified facilities performing over 25 million procedures annually, ASCs operate at the intersection of federal anti-kickback law, Stark referral prohibitions, Medicare certification requirements, state licensure standards, billing and reimbursement compliance obligations, and an increasingly aggressive enforcement environment. For healthcare attorneys, compliance officers, ASC administrators, and physician investors, navigating this landscape demands more than piecemeal guidance — it demands a comprehensive, authoritative, and immediately actionable legal reference.
Ambulatory Surgery Centers Law, Regulation, and Operations
| “I wrote these books because I kept seeing the same problems arise over and over — physician investors who didn’t understand the safe harbor requirements they were relying on, ASCs operating without compliant billing practices, administrators who had never seen a well-drafted compliance program. There was no single resource that brought all of this together in a practical, usable format. These two volumes are my attempt to fill that gap — not as a treatise for law school libraries, but as working tools for the attorneys and administrators who are in the trenches every day.” — John Fisher, Health Law Attorney |
Ambulatory Surgery Centers Law, Regulation, and Operations provides exactly that. Its nine chapters address every major dimension of Ambulatory Surgery Center law and operations: formation and development, physician investment structuring under the Anti-Kickback Statute’s safe harbors and the Stark Law, Medicare Conditions for Coverage, state licensure and accreditation, compliance program development, policies and procedures, billing and reimbursement (including the No Surprises Act and RAC audit defense), daily operations, and private equity and emerging issues. Twelve appendices — including a Model ASC Operating Agreement, AKS safe harbor compliance checklist, and state-specific regulatory supplements for six states — transform this volume into a working toolkit.
“The resource I kept reaching for in my ASC practice didn’t exist — so I wrote it.” John Fisher
This is the definitive two-volume legal reference series on ambulatory surgery centers (ASCs): Ambulatory Surgery Centers: Law, Regulation, and Operations (Volume I) and Ambulatory Surgery Centers: Advanced Topics — Litigation, Enforcement Actions, and Exit Transactions (Volume II), both in the 2026 Edition.
Includes Appendix of over 50 Surgery Center Policies and other documents.
View Appendix Index
Extensive Suite of Resources. A “Go To” Resource.
Both volumes are enhanced by an extensive suite of practical resources. Volume I includes twelve appendices (Appendices A through L) covering an ASC development checklist, an Anti-Kickback Statute safe harbor compliance checklist, a Medicare Conditions for Coverage quick reference guide, an accreditation comparison chart, a compliance program self-assessment, a policy master list, a billing reference guide, a KPI dashboard, and a private equity due diligence checklist. The volume also includes a fully annotated Model ASC Operating Agreement and three sample compliance policies addressing HIPAA privacy and security, exclusion screening, and incident reporting. Volume II provides a comprehensive legal index facilitating cross-reference between enforcement scenarios, regulatory authorities, and transactional considerations.
Together, the volumes constitute the most comprehensive legal reference currently available for attorneys, administrators, compliance professionals, and physician investors operating in the ASC space.
Volume I: Law, Regulation, and Operations provides a systematic, chapter-by-chapter analysis of every major legal and regulatory dimension of ASC practice. Its nine chapters address ASC development and formation, ownership structures and physician investment compliance (including detailed treatment of the Anti-Kickback Statute’s ASC investment safe harbors and the Stark Law’s referral prohibitions), Medicare Conditions for Coverage, state licensure and accreditation standards, compliance program construction, policies and procedures development, billing and reimbursement (with dedicated coverage of the No Surprises Act, the 60-day rule for overpayment reporting, and RAC audit defense), daily operational considerations, and the rapidly evolving landscape of private equity and emerging industry issues. The volume is designed as both a thorough analytical resource and an immediately actionable desk reference for healthcare attorneys advising ASC clients, compliance officers managing day-to-day regulatory risk, ASC administrators overseeing operations, and physician investors seeking to understand the legal dimensions of their ownership interests.
Volume II: Advanced Topics turns to the enforcement, litigation, and transactional dimensions of ASC practice that have become increasingly urgent as federal enforcement activity has intensified. The volume’s seven chapters provide in-depth guidance on False Claims Act enforcement and defense strategy, OIG investigations and the self-disclosure protocol, healthcare litigation including malpractice defense, employment disputes, and contract claims, physician disciplinary proceedings, real-world government enforcement case studies drawn from ASC-specific actions, ASC mergers and acquisitions and due diligence, and the full spectrum of ASC exit strategies — including private equity acquisitions, hospital joint ventures, internal succession planning, and wind-down scenarios. Volume II equips healthcare attorneys and their clients to anticipate, respond to, and resolve the enforcement and transactional challenges that define the contemporary ASC operating environment.
| “The enforcement environment for ASCs has changed fundamentally. DOJ False Claims Act recoveries from healthcare continue to reach into the billions annually, qui tam relators are increasingly sophisticated, and OIG audit activity targeting outpatient surgery is accelerating. The ASCs and physicians who will survive and thrive in this environment are the ones who treat compliance as a strategic priority — not as a checkbox. Volume II is written specifically to help attorneys and their clients understand what the government is looking for and how to respond effectively when they come calling.” — John Fisher, Health Law Attorney |
Complete (Volumes 1 and 2 Plus Document Appendix)
Book Set Only
Together, Volume I and Volume II provide a comprehensive, attorney-ready toolkit for navigating the legal, regulatory, operational, enforcement, and transactional issues that define the ASC industry.
Volume 1 Contents
Volume 2 Contents
Included resources feature practical checklists, compliance tools, state regulatory supplements, sample policies, a model ASC operating agreement, and a detailed legal index for fast cross-reference. [See the Forms Index]
An essential reference for professionals who advise, own, operate, or manage ambulatory surgery centers.
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