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Introduced Version Senate Bill 469 History

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Key: Green = existing Code. Red = new code to be enacted
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.]
____________


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.
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