H. B. 2579
(By Mr. Speaker, Mr. Chambers, and Delegate Ashley)
[By Request of the Executive]
[Introduced February 21, 1995; referred to the
Committee on Finance.]
A BILL to repeal articles four-b and four-c of chapter nine of the
code of West Virginia, one thousand nine hundred thirty-one,
as amended; to amend and reenact section two, article one of
said chapter; to amend article two of said chapter by adding
thereto a new section, designated section nine-a; to amend and
reenact section two, article four of said chapter; to amend
and reenact section two-b, article four-a of said chapter; to
amend and reenact section twenty-a, article thirteen-a,
chapter eleven of said code; to amend and reenact sections one
and three, article twenty-six of said chapter; to amend and
reenact section thirty-two, article twenty-seven of said
chapter; and to amend article two-d, chapter sixteen of said
code by adding thereto a new section, designated section three-a, all relating to the physician/medical practitioner
provider medicaid enhancement board and health care provider
medicaid enhancement; definitions; authorization to execute
contracts for professional health care, managed care and
actuarial services; deposits into the medical services fund of
the taxes collected under the West Virginia Health Care
Provider Tax Act of 1993 and the taxes collected from
providers of health care items or services under the Severance
and Business Privilege Tax Act of 1993; requiring the medical
services fund to be used to make expenditures for personal
services, employee benefits, current expenses, repairs and
alterations and health care provider payments of the division
of human services for the payment of medical services to
recipients of specified classes of welfare assistance;
revising the expansion of medicaid coverage to children;
legislative findings; and moratoriums on the approval of
certificates of need for new home health, hospice and mental
and behavioral health programs and sites and on the
implementation of services pursuant to an existing certificate
of need.
Be it enacted by the Legislature of West Virginia:
That articles four-b and four-c of chapter nine of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be
repealed; that section two, article one of said chapter be amended
and reenacted; that article two of said chapter be amended by
adding thereto a new section, designated section nine-a; that
section two, article four of said chapter be amended and reenacted;
that section two-b, article four-a of said chapter be amended and
reenacted; that section twenty-a, article thirteen-a, chapter
eleven of said code be amended and reenacted; that sections one and
three, article twenty-six of said chapter be amended and reenacted;
and that section thirty-two, article twenty-seven of said chapter
be amended and reenacted; and that article two-d, chapter sixteen
of said code be amended by adding thereto a new section, designated
section three-a, all to read as follows:
CHAPTER 9. HUMAN SERVICES.
ARTICLE 1. LEGISLATIVE PURPOSE AND DEFINITIONS.
§9-1-2. Definitions.
The following words and terms when used in this chapter shall
have the meaning hereafter ascribed to them unless the context
clearly indicates a different meaning,
and any amendment of this
section shall apply to any verdict, settlement, compromise or
judgment entered after the effective date of the amendment.
(a) The term "department"
shall mean means the state
department of welfare division of human services.
(b) The term "commissioner"
shall mean means the commissioner
of
welfare human services.
(c) The term "federal-state assistance"
shall mean means and
include includes (1) all forms of aid, care, assistance and
services to or on behalf of persons, which are authorized by, and
who are authorized to receive the same under and by virtue of,
subchapters one, four, five, ten, fourteen, sixteen, eighteen and
nineteen, chapter seven, Title 42, United States Code, as those
subchapters have heretofore been and may hereafter be amended,
supplemented and revised by acts of Congress, and as those
subchapters so amended, supplemented and revised have heretofore
been and may hereafter be supplemented by valid rules and
regulations promulgated by authorized federal agents and agencies,
and as those subchapters so amended, supplemented and revised have
heretofore been and may hereafter be supplemented by rules and
regulations promulgated by the state
department of welfare division
of human services, which
department division rules and regulations
shall be consistent with federal laws, rules and regulations, but
not inconsistent with state law, and (2) all forms of aid, care,
assistance and services to persons, which are authorized by, and
who are authorized to receive the same under and by virtue of, any act of Congress, other than the federal Social Security Act, as
amended, for distribution through the state
department of welfare
division of human services to recipients of any form of aid, care,
assistance and services to persons designated or referred to in (1)
of this definition and to recipients of state assistance, including
by way of illustration, surplus food and food stamps, which
Congress has authorized the secretary of agriculture of the United
States to distribute to needy persons.
(d) The term "federal assistance"
shall mean means and
include
includes all forms of aid, care, assistance and services to or on
behalf of persons, which are authorized by, and who are authorized
to receive the same under and by virtue of, any act of Congress for
distribution through the state
department of welfare division of
human services, the cost of which is paid entirely out of federal
appropriations.
(e) The term "state assistance"
shall mean means and
include
includes all forms of aid, care, assistance, services and general
relief made possible solely out of state, county and private
appropriations to or on behalf of indigent persons, which are
authorized by, and who are authorized to receive the same under and
by virtue of,
department state division of human services' rules
and regulations.
(f) The term "welfare assistance"
shall mean means the three
classes of assistance administered by the
department state division
of human services, namely: Federal-state assistance, federal
assistance and state assistance.
(g) The term "indigent person"
shall mean means any person who
is domiciled in this state and who is actually in need as defined
by department rules and regulations and has not sufficient income
or other resources to provide for such need as determined by the
department state division of human services.
(h) The term "domiciled in this state"
shall mean means being
physically present in West Virginia accompanied by an intention to
remain in West Virginia for an indefinite period of time, and to
make West Virginia his or her permanent home. The
department state
division of human services may by rules and regulations supplement
the foregoing definition of the term "domiciled in this state," but
not in such a manner as would be inconsistent with federal laws,
rules, and regulations applicable to and governing federal-state
assistance.
(i) The term "medical services" means medical, surgical,
dental and nursing services, and other remedial services recognized
by law, in the home, office, hospital, clinic and any other
suitable place, provided or prescribed by persons permitted or authorized by law to give such services; such services to include
drugs and medical supplies, appliances, laboratory, diagnostic and
therapeutic services, nursing home and convalescent care and such
other medical services and supplies as may be prescribed by such
persons.
(j) The term "general relief"
shall mean means cash or its
equivalent in services or commodities expended for care and
assistance to an indigent person other than for care in a county
infirmary, child shelter or similar institution.
(k) The term "physician provider" means an allopathic or
osteopathic physician, rendering services within this state and
receiving reimbursement, directly as an individual provider or
indirectly as an employee or agent of a medical clinic, partnership
or other business entity.
(l) The term "nurse practitioner" means a registered nurse
qualified by virtue of his or her education and credentials and
approved by the West Virginia board of examiners for registered
professional nurses to practice as an advanced practice nurse
independently or in a collaborative relationship with a physician.
(m) The term "nurse-midwife" means a qualified professional
nurse registered with the West Virginia board of examiners for
registered professional nurses who by virtue of additional training is specifically qualified to practice nurse-midwifery according to
the statement of standards for the practice of nurse-midwifery as
set forth by the American college of nurse-midwives.
(n) The term "physician assistant" means an assistant to a
physician who is a graduate of an approved program of instruction
in primary health care or surgery, has attained a baccalaureate or
master's degree, has passed the national certification examination
and is qualified to perform direct patient care services under the
supervision of a physician.
(o) The term "secretary" means the secretary of the department
of health and human resources.
(p) The term "single state agency" means the single state
agency for medicaid in this state.
(q) The term "ambulance service provider" means a person
rendering ambulance services within this state and receiving
reimbursement, directly as an individual provider or indirectly as
an employee or agent of a medical clinic, partnership or other
business entity.
(r) The term "general health care provider" means an
audiologist, a behavioral health center, a chiropractor, a
community care center, an independent laboratory, an independent X-
ray service, an occupational therapist, an optician, an optometrist, a physical therapist, a podiatrist, a private duty
nurse, a psychologist, a rehabilitative specialist, a respiratory
therapist and a speech therapist rendering services within this
state and receiving reimbursement, directly as an individual
provider or indirectly as an employee or agent of a medical clinic,
partnership or other business entity.
(s) The term "inpatient hospital services provider" means a
provider of inpatient hospital services for purposes of Section
1903(w) of the Social Security Act.
(t) The term "intermediate care facility for the mentally
retarded services provider" means a provider of intermediate care
facility services for the mentally retarded for purposes of Section
1903(w) of the Social Security Act.
(u) The term "nursing facility services provider" means a
provider of nursing facility services for purposes of Section
1903(w) of the Social Security Act.
(v) The term "outpatient hospital service provider" means a
hospital providing preventative, diagnostic, therapeutic,
rehabilitative or palliative services that are furnished to
outpatients.
(w) The term "subrogation" means a statutory right of
reimbursement in which the principles precedent for recovery at equity or common law do not apply, so that reimbursement is given
first priority regardless of whether the injured party is made
whole or whether other creditors are paid.
(x) The term "full reimbursement" means the department of
health and human resources' right of recovery of all amounts of
medical assistance paid by medicaid on behalf of the recipient
regardless of whether the recipient is made whole.
(y) The term "estate" means all real and personal property and
other assets included within the individual's estate as defined in
this state's probate law.
(z) The term "services" means nursing facility services, home
and community-based services, and related hospital and prescription
drug services for which an individual received medicaid medical
assistance.
ARTICLE 2. DEPARTMENT OF HEALTH AND HUMAN RESOURCES, AND OFFICE
OF COMMISSIONER OF HUMAN SERVICES; POWERS, DUTIES
AND RESPONSIBILITIES GENERALLY.
§9-2-9a. Authorization to execute contracts for professional
health care, managed care and actuarial services.
(a) The secretary is hereby given exclusive authorization to
execute such contract or contracts as are necessary to implement
professional health care, managed care, actuarial and independent referral systems for the medicaid program.
(b) The provisions of article three, chapter five-a of this
code, relating to the division of purchasing of the department of
administration, shall not apply to any contract or contracts for
professional health care, managed care, actuarial and independent
referral services for the medicaid program. Before entering into
any contracts for any professional health care, managed care,
actuarial and independent referral systems for the medicaid
program, as herein authorized, the secretary shall invite competent
sealed bids from all qualified providers of said services. The
secretary shall develop specifications and receive proposals and
quotations for bid purposes and may employ, without the requirement
of bidding, a consultant for developing the specifications, and any
consultant so employed shall not be disqualified from subsequent
bidding. Bids shall be obtained by public notice and by soliciting
sealed bids by sending requests to prospective providers. The
secretary shall award such contract or contracts on a competitive
bid basis. In awarding the contract or contracts, the secretary
shall take into consideration the experience of the offering
provider.
(c) The provisions of chapter thirty-three of this code,
relating to the licensing and regulation of insurance companies, shall not apply to any entity contracting with the secretary to
serve as the department of health and human resources' managed care
organization for the medicaid managed behavioral health care
program.
(d) The secretary may at the end of any contract period
discontinue any contract or contracts executed pursuant to this
article.
ARTICLE 4. STATE ADVISORY BOARD; MEDICAL SERVICES FUND; ADVISORY
COUNCIL; GENERAL RELIEF FUND.
§9-4-2. Medical services fund.
The special fund known as the state of West Virginia public
assistance medical services fund established by chapter one hundred
forty-three, acts of the Legislature, regular session, one thousand
nine hundred fifty-three, as amended by chapter two, acts of the
Legislature, first extraordinary session, one thousand nine hundred
sixty, and chapter forty-nine, acts of the Legislature, regular
session, one thousand nine hundred sixty-six, shall be continued in
accordance with the provisions of this section so long as the same
may be required by federal laws, rules and regulations applicable
to federal-state assistance and thereafter so long as the
commissioner shall deem such fund to be otherwise necessary or
desirable, and henceforth such special fund shall be known as the
department division of human services medical services fund,
hereinafter referred to as the fund.
The fund shall consist of payments made into the fund out of
state appropriations for medical services to recipients of
specified classes of welfare assistance,
taxes deposited under
subsection (a), section twenty-a, article thirteen-a, chapter
eleven of this code, commonly known as the Severance and Business
Privilege Tax Act of 1993, and under section thirty-two, article
twenty-seven of such chapter, commonly known as the West Virginia
Health Care Provider Tax Act of 1993, and such federal
grants-in-aid as are made available for specified classes of
welfare assistance. Any balance in the fund at the end of any
fiscal year shall remain in the fund and shall not expire or
revert. Payments shall be made out of the fund upon requisition of
the commissioner by means of a warrant signed by the auditor and
treasurer.
Recipients of those classes of welfare assistance as are
specified by the
department division of human services, consistent
with applicable federal laws, rules and regulations, shall be
entitled to have costs of necessary medical services paid out of
the fund, in the manner and amounts, to the extent, and for the
period determined from time to time to be feasible by the commissioner pursuant to rules, regulations and standards
established by him. Such rules, regulations and standards shall
comply with requirements of applicable federal laws, rules and
regulations and shall be established on the basis of money
available for the purpose, the number of recipients, the experience
with respect to the incidence of illness, disease, accidents, and
other causes among such recipients causing them to require medical
services and the costs thereof, the amounts which recipients
require otherwise in order to maintain a subsistence compatible
with decency and health, and any other factor considered relevant
and proper by the commissioner:
Provided, That such rules and
regulations respecting qualifications shall permit the expenditure
of state funds to pay for care rendered in any birthing center
licensed under the provisions of article two-e, chapter sixteen of
this code, by a licensed nurse midwife or midwife as this
occupation is defined in section one, article fifteen, chapter
thirty of this code, and which care is within the scope of duties
for such licensed nurse midwife or midwife as permitted by the
provisions of section seven, article fifteen of said chapter
thirty.
Expenditures of the types heretofore made by the division of
human services to support the payment of medical services to recipients of specified classes of welfare assistance, including
expenditures for personal services, employee benefits, current
expense, repairs and alterations and health care provider payments,
may be made from the fund. The identification of the recipient,
general purpose and amount of all expenditures from the fund shall
be available for public inspection, and an annual report totaling
such expenditures by type shall be available for such inspection.
This section shall be effective from date of passage.
ARTICLE 4A. MEDICAID UNCOMPENSATED CARE FUND.
§9-4A-2b. Expansion of coverage to children and terminally ill.
(a) It is the intent of the Legislature that steps be taken to
expand coverage to children and the terminally ill and to pay for
this coverage by fully utilizing federal funds. To achieve this
intention, the department of health and human resources shall
undertake the following:
(1) Effective the first day of July, one thousand nine hundred
ninety-four, the department shall initiate a streamlined
application form, which shall be no longer than two pages, for all
families applying only for medicaid coverage for children.
(2) Effective the first day of July, one thousand nine hundred
ninety-four, the department shall initiate the option of hospice
care to terminally ill West Virginians who otherwise qualify for medicaid. On or before the first day of January, one thousand nine
hundred ninety-five, and periodically thereafter, the department
shall report to the legislative task force on uncompensated health
care and medicaid expenditures created pursuant to section four,
article twenty-nine-c, chapter sixteen of this code regarding the
program initiation provided for in this subdivision. The report
shall include, but not be limited to, the total number, by age, of
newly eligible clients served as a result of the initiation of the
program pursuant to this subdivision, the average annual cost of
coverage per client, and the total cost, by provider type, to serve
all clients.
(3) Effective the first day of July, one thousand nine hundred
ninety-four, the department shall accelerate the medicaid option
for coverage of medicaid to all West Virginia children whose family
income is below one hundred percent of the federal poverty level.
On or before the first day of January, one thousand nine hundred
ninety-five, and periodically thereafter, the department shall
report to the legislative task force on uncompensated health care
and medicaid expenditures regarding the program acceleration
provided for in this subdivision. The report shall include, but
not be limited to, the number of newly eligible clients, by age,
served as a result of the acceleration, the average annual cost of coverage per client and the total cost of all clients served by
provider type.
(4) Effective the first day of July, one thousand nine hundred
ninety-five ninety-six, the department may initiate the medicaid
option to expand coverage of medicaid to all West Virginia children
whose family income is below one hundred thirty-three percent of
the federal poverty level.
To prepare for Prior to any such
program expansion,
but no earlier than the first day of January,
one thousand nine hundred ninety-six, the department shall submit
a report to the governor and the Legislature
on the first day of
January, one thousand nine hundred ninety-five, regarding the
feasibility of the expansion. The report is to include, but not be
limited to, the number of newly eligible clients participating in
the programs specified in this section, the average annual cost of
coverage per client, the percentage of expected participation for
the expansion, the projected cost of the expansion, the medical
services trust fund balance and the future disproportionate share
moneys expected to be deposited in the medical services trust fund
pursuant to section two-a of this article. The department shall
continually update the additional information required to be
provided to the governor and the Legislature regarding this
expansion and periodically report the information to the legislative task force on uncompensated health care and medicaid
expenditures created pursuant to section four, article twenty-
nine-c, chapter sixteen of this code.
(5) Effective the first day of July, one thousand nine hundred
ninety-six ninety-seven, the department may initiate the medicaid
option to expand coverage of medicaid to all West Virginia children
whose family income is below one hundred fifty percent of the
federal poverty level.
To prepare for Prior to any such program
expansion,
but no earlier than the first day of January, one
thousand nine hundred ninety-seven, the department shall submit a
report to the governor and the Legislature
on the first day of
January, one thousand nine hundred ninety-six, regarding the
feasibility of the expansion. Additionally, the report is to
include, but not be limited to, the number of clients who would be
newly eligible to participate in the program, the average annual
cost of coverage per client, by age, the percentage of expected
participation for the expansion and the projected cost of the
expansion, the balance of the medical services trust fund and the
future disproportionate share moneys expected to be deposited in
the medical services trust fund pursuant to section two-a of this
article. The department shall periodically update and report to
the legislative task force on uncompensated health care and medicaid expenditures created pursuant to section four, article
twenty-nine-c, chapter sixteen of this code regarding the
additional information required to be submitted to the governor and
the Legislature.
(6) The provisions of this section shall not be construed as
requiring the department to expand medicaid coverage to children
after the first day of July, one thousand nine hundred ninety-four.
(b) Notwithstanding the provisions of section two-a of this
article, the accruing interest in the medical services trust fund
may be utilized to pay for the programs specified in subsection (a)
of this section:
Provided, That to the extent the accrued interest
is not sufficient to fully fund the specified programs, the
disproportionate share hospital funds paid into the medical
services trust fund after the thirtieth day of June, one thousand
nine hundred ninety-four, may be applied to cover the cost of the
specified programs:
Provided, however, That in fiscal year one
thousand nine hundred ninety-five, the amount of funds applied from
the disproportionate share funds, not including accrued interest,
shall not exceed ten million dollars:
Provided further, That in
the interest of fiscal responsibility, the department shall
terminate the program specified in subdivisions (4) and (5) of
subsection (a) of this section, if the future moneys deposited from disproportionate share payments in the medical services trust fund
are insufficient to cover the cost of the expanded program.
(c) On the first day of January, one thousand nine hundred
ninety-five and annually thereafter, the department shall report to
the governor and to the Legislature information regarding the
number of children and elderly covered by the program, the cost of
services by type of service provided, a cost-benefit analysis of
the acceleration and expansion on other insurers and the reduction
of uncompensated care in hospitals as a result of the programs.
(d) The health care cost review authority established by
section five, article twenty-nine-b of this chapter shall consider
in its rate review that uncompensated care and charity care are
reduced by the programs specified in subsection (a) of this section
and shall take the reduction into account when determining rates.
This determination shall be undertaken in each hospital's next rate
review and shall be determined prospectively.
(e) On the first day of January, one thousand nine hundred
ninety-five, and annually thereafter, the health care cost review
authority shall present to the governor and to the Legislature a
report concerning the reduction in cost shift created by the
operation of the provisions of this article.
(f) The department shall review the additional utilization by behavioral health centers as a result of the acceleration and
expansion for a period of eighteen months from the enactment of
this article:
Provided, That during the eighteen-month study
period the department shall not issue additional behavioral health
licenses:
Provided, however, That this license provision does not
apply to facilities filing for renewal applications
or to any
health care facility which has a certificate of need in effect or
an application pending on the first day of March, one thousand nine
hundred ninety-four:
Provided further, That this licensure
prohibition shall not apply to behavioral health services provided
pursuant to any agreement for state owned psychiatric hospitals
which are approved by the federal health care finance
administration.
CHAPTER 11. TAXATION.
ARTICLE 13A. SEVERANCE TAXES.
§11-13A-20a. Dedication of tax.
(a) The amount of taxes collected under this article from
providers of health care items or services, including any interest,
additions to tax and penalties collected under article ten of this
chapter, less the amount of allowable refunds and any interest
payable with respect to such refunds, shall be deposited into the
division of human services medical services fund named in section two, article four, chapter nine of this code. Any funds remaining
on the last day of June, one thousand nine hundred ninety-five, in
the special revenue fund created in the state treasurer's office
and known as the medicaid state share fund
shall be transferred to
the division of human services medical services fund, and any
subsequent deposits in the medicaid state share fund shall also be
so transferred. Said fund shall have separate accounting for those
health care providers
as set forth in articles four-b and four-c
defined in section two, article one, chapter nine of this code.
(b) Notwithstanding the provisions of subsection (a) of this
section, for the remainder of fiscal year one thousand nine hundred
ninety-three and for each succeeding fiscal year, no expenditures
from taxes collected from providers of health care items or
services are authorized except in accordance with appropriations by
the Legislature.
(c) The amount of taxes on the privilege of severing timber
collected under section three-b of this article, including any
interest, additions to tax and penalties collected under article
ten of this chapter, less the amount of allowable refunds and any
interest payable with respect to such refunds, shall be paid into
a special revenue account in the state treasury to be appropriated
by the Legislature for purposes of the division of forestry.
(d) The amount of taxes collected under this article from all
other persons, including any interest, additions to tax and
penalties collected under article ten of this chapter, less the
amount of allowable refunds and any interest payable with respect
to such refunds, shall be deposited into the general revenue fund.
ARTICLE 26. HEALTH CARE PROVIDER MEDICAID TAX.
§11-26-1. Legislative findings.
The Legislature finds and declares that:
(a) Medicaid provides access to basic medical care for our
citizens who are not physically, mentally or economically able to
provide for their own care;
(b) Inadequate compensation for health care providers
rendering medicaid services is a barrier to indigent persons
seeking access to health care services;
(c) Health care providers in this state are providing care,
without compensation, to many citizens who are not medicaid
eligible;
(d) Many health care providers are leaving this state due to
economic conditions;
(e) Without adequate compensation this state cannot attract or
retain a sufficient number of health care providers necessary to
serve our indigent population;
(f) Without additional medicaid funding this state cannot
adequately compensate health care providers for the health care
services rendered to indigent patients;
(g) The Tenth Amendment of the United States Constitution
guarantees to the states the power to tax;
(h) The Congress of the United States has enacted Section 4701
of the Omnibus Budget Reconciliation Act of 1990, P.L. 101-508,
amending Section 1902 of the Social Security Act and authorizing
state medicaid agencies to attribute taxes imposed on medicaid
providers as part of the state share;
(i) By levying a tax on the medicaid reimbursements of health
care providers for the purpose of meeting state fund matching
requirements pursuant to Title XIX of the Social Security Act,
federal matching funds will be increased;
(j) By dedicating such additional revenue to the medicaid
program, health care provider fees may conform as closely as
possible to usual and customary charges;
(k) (i) Moneys generated in accordance with this article are
supplementary only and shall not be used to reduce the general
financial obligations of the state's medical assistance program as
appropriated by the Legislature;
and
(l) (j) These funds shall not be used for any purpose other than those purposes stated in this article.
and articles four-b
and four-c, chapter nine of this code; and
(m) The medicaid enhancement boards and medicaid enhancement
funds created pursuant to articles four-b and four-c, chapter nine
of this code are created to carry out the purposes of this article.
§11-26-3. Definitions.
The following words when used in this article have the meaning
ascribed to them in this section, except in those instances where
a different meaning is distinctly expressed or the context in which
the word is used clearly indicates a different meaning is intended:
(a) "Cost-based service" means any service delivered by a
health care provider reimbursed under the medical assistance
program of this state solely on the basis of costs reported to the
single state agency, whether or not the provider is operating on a
profit or not-for-profit basis.
(b) "Department" means the West Virginia department of health
and human resources. The term "secretary" means the secretary of
the West Virginia department of health and human resources, or his
or her designee.
(c) "Gross receipts" or "gross proceeds" means all payments
received by a health care provider enrolled in this state's medical
assistance program for services delivered pursuant to Title XIX of the United States Social Security Act, as amended, and means any
and all medicaid reimbursement payments made by the West Virginia
department of health and human resources, or a division thereof,
within the limitations set forth in this subsection, to such health
care provider:
Provided, That this definition does not include
payments received for medicare coinsurance and deductibles as
defined in Title XVIII of the Social Security Act, and does not
include reimbursements made for cost-based services.
(d) "Health care provider" or "provider" includes physician
providers,
as defined in section one, article four-b, chapter nine
of this code, ambulance service providers, dentist providers,
general health care providers, and outpatient hospital service
providers as defined in section
one two, article
four-c one,
chapter nine of this code, and any other person directly receiving
enhanced medicaid reimbursement payments.
pursuant to article
four-b or four-c, chapter nine of this code
(e) "Single state agency" means the single state agency for
medicaid in this state.
(f) "Taxpayer" means a health care provider required to pay
the medicaid enhancement tax imposed by this article.
and entitled
to receive the increased reimbursement in accordance with article
four-b or four-c, chapter nine of this code
ARTICLE 27. HEALTH CARE PROVIDER TAXES.
§11-27-32. Dedication of tax.
(a) The amount of taxes collected under this article,
including any interest, additions to tax and penalties collected
under article ten of this chapter, less the amount of allowable
refunds, the amount of any interest payable with respect to such
refunds, and costs of administration and collection, shall be
deposited into the
division of human services medical services fund
named in section two, article four, chapter nine of this code. Any
funds remaining on the last day of June, one thousand nine hundred
ninety-five, in the special revenue fund created in the state
treasurer's office and known as the medicaid state share fund
shall
be transferred to the division of human services medical services
fund, and any subsequent deposits in the medicaid state share fund
shall also be so transferred. The tax commissioner shall have
separate accounting for those health care providers
as set forth in
articles four-b and four-c defined in section two, article one,
chapter nine of this code, except that taxes paid by hospitals may
be combined and reported as a single item. The tax commissioner
shall retain from the taxes collected during each fiscal year the
amount of two hundred thousand dollars to be used for
administration and collection of these taxes.
(b) Notwithstanding the provisions of subsection (a) of this
section, for the remainder of fiscal year one thousand nine hundred
ninety-three and for each succeeding fiscal year, no expenditures
from any of the several health care provider funds are authorized
except in accordance with appropriations by the Legislature.
CHAPTER 16. PUBLIC HEALTH.
ARTICLE 2D. CERTIFICATE OF NEED.
§16-2D-3a. Moratoriums on letters of intent and applications for
certificates of need for home health, hospice, group
residential facilities and mental and behavioral
health facilities.
(a) There shall be a moratorium on the filing of letters of
intent and applications for all certificates of need for new
services within agencies and facilities which provide or propose to
provide home health services, as described in article two-c of this
chapter, and upon new sites by any facility, agency or service
which offers or seeks to offer such services. This moratorium
shall end on the first day of August, one thousand nine hundred
ninety-seven. No agency, facility or service shall tender a letter
of intent or application for a certificate of need for such
services prior to that date.
(b) There shall be a moratorium on the filing of letters of intent and applications for all certificates of need for new
services within those agencies or facilities which provide or
propose to provide hospices and bereavement services, as described
in article five-i of this chapter, and upon new sites by any
facility, agency or service which offers or seeks to offer such
services. This moratorium shall end on the first day of August,
one thousand nine hundred ninety-seven. No agency, facility or
service shall tender a letter of intent or application for a
certificate of need for such services prior to that date.
(c) There shall be a moratorium on the filing of letters of
intent and applications for all certificates of need for new
services within those agencies or facilities which provide or
propose to provide group residential facility services, mental and
behavioral health services, and any other services governed by
chapter twenty-seven of this code, as amended, and upon new sites
by any facility, agency or service which offers or seeks to offer
such services, except that this moratorium shall not apply to
agencies or facilities which seek a certificate of need: For the
sole purpose of creating placements, services, programs or sites
for individuals who were residents of the Colin Anderson Center on
or after the first day of January, one thousand nine hundred
ninety-five, or for individuals displaced by residents of Colin Anderson Center moving into community-based settings; for the
purpose of creating placements, services, programs or sites
necessary to prevent individuals from being institutionalized; or
for the purpose of creating placements, services, programs or sites
for specialized foster care. This moratorium shall end on the
first day of August, one thousand nine hundred ninety-seven or upon
the date of implementation of a medicaid managed behavioral health
plan, whichever occurs first. No agency, facility or service
subject to this moratorium shall tender a letter of intent or
pursue application for a certificate of need for such services
prior to that date unless the stated purpose: Is to provide
placements, services, programs or sites for individuals who were
residents of the Colin Anderson Center on or after the first day of
January, one thousand nine hundred ninety-five, or for individuals
displaced by residents of Colin Anderson Center moving into
community-based settings; is to create placements, services,
programs or sites necessary to prevent individuals from being
institutionalized; or is to create placements, services, programs
or sites for specialized foster care.
(d) No extensions beyond the twelve month period from
certificate of need approval shall be granted for those facilities,
agencies and services described in subsections (a), (b) and (c) of this section. This subsection shall apply only to those
certificates approved after the twenty-ninth day of January, one
thousand nine hundred ninety-five and prior to the effective date
of this section.
(e) A substantial change of a pending or approved certificate
of need for those services described in subsections (a), (b) and
(c) shall be subject to the moratorium imposed by this section.
NOTE: The purposes of this bill are to: Revise and
reorganize definitions; provide for the authorization to execute
contracts for professional health care, managed care and actuarial
services; provide for the deposit into the medical services fund of
the taxes collected under the West Virginia Health Care Provider
Tax Act of 1993 and the taxes collected from providers of health
care items or services under the Severance and Business Privilege
Tax Act of 1993; to specify that the medical services fund be used
to make the certain administrative and other expenditures
heretofore made by the division of human services for the Medicaid
program; place a mandatory one-year moratorium on expansion of
medicaid coverage for children; place an eighteen month moratorium
on the filing of letters of intent and applications for certain
certificates of need and to place a moratorium on extensions of
certain certificates of need approved after July 29, 1995; and to
abolish the physician/medical practitioner provider medicaid
enhancement board, general medicaid enhancement board, dentist
provider medicaid enhancement board, ambulance service provider
medicaid enhancement board, and facility providers' medicaid
enhancement board.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added, except §§ 9-2-9a and 16-2D-3a are new; therefore,
underlining and strike-throughs have been omitted in them.