Senate Bill No. 311
(By Senator Bailey)
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[Introduced February 10, 1995; referred to the Committee
on Health and Human Resources; and then to the Committee
on Finance.]
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A BILL to amend and reenact section three, article twenty-nine-b,
chapter sixteen of the code of West Virginia, one thousand
nine hundred thirty-one, as amended, relating to exemption
of rural hospitals and swing beds; and limited exemption for
small hospitals.
Be it enacted by the Legislature of West Virginia:
That section three, article twenty-nine-b, chapter sixteen
of the code of West Virginia, one thousand nine hundred
thirty-one, as amended, be amended and reenacted to read as
follows:
ARTICLE 29B. HEALTH CARE COST REVIEW AUTHORITY.
§16-29B-3. Definitions.
As used in this article, unless a different meaning clearly appears from the context:
(a) "Charges" means the economic value established for
accounting purposes of the goods and services a hospital provides
for all classes of purchasers;
(b) "Class of purchaser" means a group of potential hospital
patients with common characteristics affecting the way in which
their hospital care is financed. Examples of classes of
purchasers are medicare beneficiaries, welfare recipients,
subscribers of corporations established and operated pursuant to
article twenty-four, chapter thirty-three of this code, members
of health maintenance organizations and other groups as defined
by the board;
(c) "Board" means the three member board of directors of the
West Virginia health care cost review authority, an autonomous
division within the state department of health;
(d) "Health care provider" means a person, partnership,
corporation, facility or institution licensed, certified or
authorized by law to provide professional health care service in
this state to an individual during this individual's medical
care, treatment or confinement;
(e) "Hospital" means a facility subject to licensure as such under the provisions of article five-b of this chapter and any
acute care facility operated by the state government which is
primarily engaged in providing to inpatients, by or under the
supervision of physicians, diagnostic and therapeutic services
for medical diagnosis, treatment and care of injured, disabled or
sick persons, and does not include state mental health facilities
or state long-term care facilities except rural primary care
hospitals and swing beds that are used for long-term care and
respite services which are exempt from rate review, and except
hospitals having less than seventy-five acute beds and no less
than fifty percent or more of the hospital's revenues is derived
from governmental payors which shall be reviewed every three
years;
(f) "Person" means an individual, trust, estate,
partnership, committee, corporation, association or other
organization such as a joint stock company, estate or political
subdivision or instrumentality thereof;
(g) "Purchaser" means a consumer of patient care services,
a natural person who is directly or indirectly responsible for
payment for such patient care services rendered by a hospital,
but does not include third-party payors;
(h) "Rates" means all value given or money payable to
hospitals for health care services, including fees, charges and
cost reimbursements;
(i) "Records" means accounts, books and other data related
to health care costs at health care facilities subject to the
provisions of this article which do not include privileged
medical information, individual personal data, confidential
information, the disclosure of which is prohibited by other
provisions of this code and the laws enacted by the federal
government, and information, the disclosure of which would be an
invasion of privacy;
(j) "Third-party payor" means any natural person, person,
corporation or government entity responsible for payment for
patient care services rendered by hospitals; and
(k) "Related organization" means an organization, whether
publicly owned, nonprofit, tax-exempt or for profit, related to
a hospital through common membership, governing bodies, trustees,
officers, stock ownership, family members, partners or limited
partners including, but not limited to, subsidiaries,
foundations, related corporations and joint ventures. For the
purposes of this subsection family members shall mean brothers and sisters, whether by the whole or half blood, spouse,
ancestors and lineal descendents.
NOTE: The purpose of this bill is to exempt from review
rural primary care hospitals and small hospitals.
Strike-throughs indicate language that would be stricken
from the present law, and underscoring indicates new language
that would be added.