HB4607 SFA Rucker #1 3-12
Dellinger 7965
Senator Rucker moved to amend Health and Human Resources committee amendment on page two, section eight, line forty-two, by striking out the words “(1) Constructing, developing, acquiring, or establishing a birthing center”;
By renumbering the remaining subdivisions;
On page five, section nine, line sixteen, by striking out the word “License” and inserting in lieu thereof the word “Licensure”;
And,
On page five, section nine, after line eighteen, by inserting the following:
§16-2D-10. Exemptions from certificate of need.
Notwithstanding section
eight§16-2D-8 of this code, a person may provide the following
health services without obtaining a certificate of need or applying to the
authority for approval:
(1) The creation of a private office of one or more licensed health professionals to practice in this state pursuant to chapter thirty of this code;
(2) Dispensaries and
first-aid stations located within business or industrial establishments maintained
solely for the use of employees that does not contain inpatient or resident
beds for patients or employees who generally remain in the facility for more
than twenty-four 24 hours;
(3) A place that provides remedial care or treatment of residents or patients conducted only for those who rely solely upon treatment by prayer or spiritual means in accordance with the creed or tenets of any recognized church or religious denomination;
(4) Telehealth;
(5) A facility owned or
operated by one or more health professionals authorized or organized pursuant
to chapter thirty or ambulatory health care facility which offers laboratory
services or diagnostic imaging to patients regardless of the cost associated
with the proposal. To qualify for this exemption seventy-five 75
percent of the laboratory services are for the patients of the practice or
ambulatory health care facility of the total laboratory services performed and seventy-five
75 percent of diagnostic imaging services are for the patients of the
practice or ambulatory health care facility of the total imaging services
performed. The authority may, at any time, request from the entity information
concerning the number of patients who have been provided laboratory services or
diagnostic imaging;
(6)(A) Notwithstanding the
provisions of section seventeen of this article §16-2D-17 of this
code, any hospital that holds a valid certificate of need issued pursuant
to this article, may transfer that certificate of need to a person purchasing
that hospital, or all or substantially all of its assets, if the hospital is
financially distressed. A hospital is financially distressed if, at the time of
its purchase:
(i) It has filed a petition for voluntary bankruptcy;
(ii) It has been the subject of an involuntary petition for bankruptcy;
(iii) It is in receivership;
(iv) It is operating under a forbearance agreement with one or more of its major creditors;
(v) It is in default of its obligations to pay one or more of its major creditors and is in violation of the material, substantive terms of its debt instruments with one or more of its major creditors; or
(vi) It is insolvent: evidenced by balance sheet insolvency and/or the inability to pay its debts as they come due in the ordinary course of business.
(B) A financially
distressed hospital which is being purchased pursuant to the provisions of this
subsection shall give notice to the authority of the sale thirty 30
days prior to the closing of the transaction and shall file simultaneous with
that notice evidence of its financial status. The financial status or
distressed condition of a hospital shall be evidenced by the filing of any of
the following:
(i) A copy of a forbearance agreement;
(ii) A copy of a petition for voluntary or involuntary bankruptcy;
(iii) Written evidence of receivership, or
(iv) Documentation establishing the requirements of subparagraph (v) or (vi), paragraph (A) of this subdivision. The names of creditors may be redacted by the filing party.
(C) Any substantial change to the capacity of services offered in that hospital made subsequent to that transaction would remain subject to the requirements for the issuance of a certificate of need as otherwise set forth in this article.
(D) Any person purchasing a financially distressed hospital, or all or substantially all of its assets, that has applied for a certificate of need after January 1, 2017, shall qualify for an exemption from certificate of need;
(7) The acquisition by a
qualified hospital which is party to an approved cooperative agreement as
provided in section twenty-eight, article twenty-nine-b, chapter sixteen
§16-29B-28 of this code, of a hospital located within a distance of
twenty highway miles of the main campus of the qualified hospital; and
(8) The acquisition by a hospital of a physician practice group which owns an ambulatory surgical center as defined in this article; and
(9) Constructing, developing, acquiring, or establishing a birthing center.
§16-2D-11. Exemptions from Certificate of Need which require the submission of information to the authority.
(a) To obtain an exemption under this section a person shall:
(1) File an exemption application; and
(2) Provide a statement detailing which exemption applies and the circumstances justifying the exemption.
(b) Notwithstanding section
eight §16-2D-8 of this code and ten §16-2D-10 of
this code and except as provided in
section nine of this article, the Legislature finds that a need exists and
these health services are exempt from the certificate of need process:
(1) The acquisition and
utilization of one computed tomography scanner with a purchase price up to
$750,000 that is installed in a private office practice where at minimum seventy-five
75 percent of the scans are performed on the patients of the practice.
The private office practice shall obtain and maintain accreditation from the
American College of Radiology prior to, and at all times during, the offering
of this service. The authority may at any time request from the private office
practice information relating to the number of patients who have been provided
scans and proof of active and continuous accreditation from the American
College of Radiology. If a physician owns or operates a private office
practice in more than one location, this exemption shall only apply to the
physician’s primary place of business, and if a physician wants to expand the
offering of this service to include more than one computed topography scanner,
he or she shall be required to obtain a certificate of need prior to expanding
this service. All current certificates of need issued for computed tomography
services, with a required percentage threshold of scans to be performed on
patients of the practice in excess of seventy-five 75 percent,
shall be reduced to seventy-five 75 percent: Provided, That
these limitations on the exemption for a private office practice with more than
one location shall not apply to a private office practice with more than twenty
locations in the state on April 8, 2017.
(2) (A) A birthing
center established by a nonprofit primary care center that has a community
board and provides primary care services to people in their community without
regard to ability to pay; or
(B) A birthing center
established by a nonprofit hospital with less than one hundred licensed acute
care beds.
(i) To qualify for this
exemption, an applicant shall be located in an area that is underserved with
respect to low-risk obstetrical services; and
(ii) Provide a proposed
health service area.
(3) (A) A health care facility acquiring major medical
equipment, adding health services, or obligating a capital expenditure to be
used solely for research;
(B) To qualify for this exemption, the health care facility shall show that the acquisition, offering, or obligation will not:
(i) Affect the charges of the facility for the provision of medical or other patient care services other than the services which are included in the research;
(ii) Result in a substantial change to the bed capacity of the facility; or
(iii) Result in a substantial change to the health services of the facility.
(C) For purposes of this subdivision, the term “solely for research” includes patient care provided on an occasional and irregular basis and not as part of a research program;
(4) (3) The obligation of a capital expenditure to
acquire, either by purchase, lease, or comparable arrangement, the real
property, equipment, or operations of a skilled nursing facility: Provided, That a skilled nursing facility
developed pursuant to subdivision (17)(15) of this section and
subsequently acquired pursuant to this subdivision may not transfer or sell any
of the skilled nursing home beds of the acquired skilled nursing facility until
the skilled nursing facility has been in operation for at least ten 10
years.
(5) (4) Shared health services between two or more
hospitals licensed in West Virginia providing health services made available
through existing technology that can reasonably be mobile. This exemption does
not include providing mobile cardiac catheterization;
(6) (5) The acquisition, development, or
establishment of a certified interoperable electronic health record or
electronic medical record system;
(7) (6) The addition of forensic beds in a health
care facility;
(8) (7) A behavioral health service selected by
the Department of Health and Human Resources in response to its request for
application for services intended to return children currently placed in
out-of-state facilities to the state or to prevent placement of children in
out-of-state facilities is not subject to a certificate of need;
(9) (8) The replacement of major medical equipment
with like equipment, only if the replacement major medical equipment cost is
more than the expenditure minimum;
(10) (9) Renovations within a hospital, only if the
renovation cost is more than the expenditure minimum. The renovations may not
expand the health care facility’s current square footage, incur a substantial
change to the health services, or a substantial change to the bed capacity;
(11) (10) Renovations to a skilled nursing
facility;
(12) (11) The donation of major medical equipment
to replace like equipment for which a certificate of need has been issued and
the replacement does not result in a substantial change to health services.
This exemption does not include the donation of major medical equipment made to
a health care facility by a related organization;
(13) (12) A person providing specialized foster
care personal care services to one individual and those services are delivered
in the provider’s home;
(14) (13) A hospital converting the use of beds
except a hospital may not convert a bed to a skilled nursing home bed and
conversion of beds may not result in a substantial change to health services
provided by the hospital;
(15) (14) The construction, renovation, maintenance,
or operation of a state-owned veterans skilled nursing facilities established
pursuant to the provisions of article one-b of this chapter §16-1B-1 et
seq. of this code;
(16) (15) To
develop and operate a skilled nursing facility with no more than thirty-six
36 beds in a county that currently is without a skilled nursing
facility;
(17) (16) A critical access hospital, designated by
the state as a critical access hospital, after meeting all federal eligibility
criteria, previously licensed as a hospital and subsequently closed, if it
reopens within ten 10 years of its closure;
(18) (17) The establishing of a heath care facility
or offering of health services for children under one year of age suffering
from Neonatal Abstinence Syndrome;
(19) (18) The construction, development,
acquisition, or other establishment of community mental health and intellectual
disability facility;
(20) (19) Providing behavioral health facilities
and services;
(21) (20) The construction, development,
acquisition, or other establishment of kidney disease treatment centers,
including freestanding hemodialysis units but only to a medically underserved
population;
(22) (21) The transfer, purchase, or sale of
intermediate care or skilled nursing beds from a skilled nursing facility or a
skilled nursing unit of an acute care hospital to a skilled nursing facility
providing intermediate care and skilled nursing services. The Department of
Health and Human Resources may not create a policy which limits the transfer,
purchase, or sale of intermediate care or skilled nursing beds from a skilled
nursing facility or a skilled nursing unit of an acute care hospital. The
transferred beds shall retain the same certification status that existed at the
nursing home or hospital skilled nursing unit from which they were acquired.
If construction is required to place the transferred beds into the acquiring
nursing home, the acquiring nursing home has one year from the date of purchase
to commence construction;
(23) (22) The construction, development,
acquisition, or other establishment by a health care facility of a nonhealth
related project, only if the nonhealth related project cost is more than the
expenditure minimum;
(24) (23) The construction, development,
acquisition, or other establishment of an alcohol or drug treatment facility
and drug and alcohol treatment services unless the construction, development,
acquisition or other establishment is an opioid treatment facility or programs
as set forth in subdivision (4) (22) of section nine of this
article;
(25) (24) Assisted living facilities and services;
(26) (25) The creation, construction, acquisition,
or expansion of a community-based nonprofit organization with a community board
that provides or will provide primary care services to people without regard to
ability to pay and receives approval from the Health Resources and Services
Administration; and
(27) (26) The acquisition and utilization of one
computed tomography scanner and/or one magnetic resonance imaging scanner with
a purchase price of up to $750,000 by a hospital.
Adopted
Rejected