Mr. Wasserman directed the committee to the second handout from the Federated Ambulatory Surgery Association about the potential to lower costs in the Medicare program. He mentioned a debate that is going on at the federal level regarding what procedures are covered in the program for example they cannot operate on a lesion bigger than a certain size and so on. He stated that currently, Medicare does not cover implants at surgery centers but they do in hospitals. Mr. Wasserman indicated that Colorado surgery centers are distinguished from hospitals and are covered under chapter twenty of the Health Department regulations, they have their own statutory definitions, are treated differently, and they are licensed by the Department of Public Health and Environment. He stated most of the centers have state of the art technologies. Then he discussed that surgical centers exist because physicians are fed up with how hospitals are set up. For example, in a hospital, surgical patients can get bumped causing them to be under anesthesia for longer than they should. He stated surgery centers are more efficient. Mr. Wasserman stressed that the centers are providing advanced affordable care and access to that care. He explained that the centers have the resources to handle a lot more procedures then they currently do. Senator Keller asked why. Mr. Wasserman responded that it is because a lot of people do not know about surgery centers and not all surgery centers have access to insurance networks. Representative McCluskey asked how many surgery centers are physician owned. Mr. Wasserman stated the majority are physician owned, some are company owned and some are partly owned by hospital systems. 03:13 PM Jennifer Arellano spoke about the Pueblo Surgery Center where she has been the Administrator for six years. She stressed that ambulatory surgery centers are there for the people and their communities. She talked about the centers current Medicare mix and what the center provides. Ms. Arellano stated that ambulatory centers provide another choice to patients and physicians and provide a safe, friendly, and comfortable environment. Ms. Arellano closed by inviting the committee to visit an ambulatory surgery center. Senator Keller brought up a concern that physicians might refer their patients to the surgery centers for profit reasons. Mr. Wasserman disagreed and stated that rarely would a physician sit in an emergency room and pick out the patients they wanted, and even if they did, they would be breaking a bunch of ethical rules. Ms. Arellano added that if a doctor who is a partner in their center, refers a patient to their center, the patient is informed that the doctor has is a partner in the center.