Senate Bill No. 469
(By Senators Tomblin, Mr. President, and Boley,
By Request of the Executive)
____________
[Introduced February 20, 1995; referred to the Committee
on Health and Human Resources; and then to the Committee
on Finance.]
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A BILL to repeal articles four-b and four-c, 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, 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be repealed; that section two, article one of said chapter be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; 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 4. STATE ADVISORY BOARD; MEDICAL SERVICES FUND; ADVISORY
COUNCIL; GENERAL RELIEF FUND.
§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.
§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.