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2000 SESSION
006081760Patrons-- Hamilton, Christian, Crittenden, Diamonstein, Griffith, Jones, J.C., Larrabee, Nixon, Rust and Spruill; Senators: Martin and Schrock
Be it enacted by the General Assembly of Virginia:
1. That § 32.1-102.1 of the Code of Virginia is amended and reenacted as follows:
§ 32.1-102.1. Definitions.
As used in this article, unless the context indicates otherwise:
[ “Cancer care center” means any specialized center or clinic or that portion of a physician’s office developed for the provision of chemotherapy, radiation, and diagnostic radiology services on an outpatient basis and that does not administer general anesthesia in connection with such services. ]
"Certificate" means a certificate of public need for a project required by this article.
"Clinical health service" means a single diagnostic, therapeutic, rehabilitative, preventive or palliative procedure or a series of such procedures that may be separately identified for billing and accounting purposes.
"Health planning region" means a contiguous geographical area of the Commonwealth with a population base of at least 500,000 persons which is characterized by the availability of multiple levels of medical care services, reasonable travel time for tertiary care, and congruence with planning districts.
"Medical care facility," as used in this title, means any institution, place, building or agency, whether or not licensed or required to be licensed by the Board or the State Mental Health, Mental Retardation and Substance Abuse Services Board, whether operated for profit or nonprofit and whether privately owned or privately operated or owned or operated by a local governmental unit, (i) by or in which health services are furnished, conducted, operated or offered for the prevention, diagnosis or treatment of human disease, pain, injury, deformity or physical condition, whether medical or surgical, of two or more nonrelated mentally or physically sick or injured persons, or for the care of two or more nonrelated persons requiring or receiving medical, surgical or nursing attention or services as acute, chronic, convalescent, aged, physically disabled or crippled or (ii) which is the recipient of reimbursements from third-party health insurance programs or prepaid medical service plans. For purposes of this article, only the following medical care facilities shall be subject to review:
1. General hospitals.
2. Sanitariums.
3. Nursing homes.
4. Intermediate care facilities.
5. Extended care facilities.
6. Mental hospitals.
7. Mental retardation facilities.
8. Psychiatric hospitals and intermediate care facilities established primarily for the medical, psychiatric or psychological treatment and rehabilitation of alcoholics or drug addicts.
9. Specialized centers or clinics or that portion of a physician's office
developed for the provision of outpatient or ambulatory surgery, cardiac
catheterization, computed tomographic (CT) scanning, gamma knife surgery,
lithotripsy, magnetic resonance imaging (MRI), magnetic source imaging (MSI),
positron emission tomographic (PET) scanning, radiation therapy, nuclear
medicine imaging, or such other specialty services as may be designated by the
Board by regulation; however, "medical care facility" shall not include any [
specialized center or clinic or that portion of a physician's office developed for the
provision of outpatient cancer treatment, regardless of whether providing
services covered by this chapter, so long as general anesthesia is not
administered in connection with such outpatient cancer treatment cancer care
center, regardless of whether providing services covered by this chapter, so
long as any such services provided to indigent patients are provided without regard
to compensation so long as the cancer care center does not take into any
regard the ability to pay of any patient with cancer or any patient referred in
regards to a diagnosis of cancer in providing any needed chemotherapy,
radiation, or diagnostic radiology services to such patients. Each cancer care
center shall report annually to the Department of Medical Assistance Services
regarding indigent care provided in accordance with this provision. ]
10. Rehabilitation hospitals.
11. Any facility licensed as a hospital.
The term "medical care facility" shall not include any facility of (i) the
Department of Mental Health, Mental Retardation and Substance Abuse Services;
or (ii) any nonhospital substance abuse residential treatment program operated
by or contracted primarily for the use of a community services board under the
Department of Mental Health, Mental Retardation and Substance Abuse Services'
Comprehensive Plan; or (iii) a physician's office, except that portion of a
physician's office described above in subdivision 9 of the definition of
"medical care facility"; or (iv) the Woodrow Wilson Rehabilitation Center of
the Department of Rehabilitative Services; or (v) [ any specialized center or
clinic or that portion of a physician's office developed for the provision of outpatient cancer
treatment, regardless of whether providing services covered by this chapter; however, general
anesthesia shall not be administered in connection with such outpatient cancer
treatment any cancer care center, regardless of whether providing services
covered by this chapter, so long as any such services provided to indigent
patients are provided without regard to compensation so long as the cancer care
center does not take into any regard the ability to pay of any patient with cancer or any patient referred
in regards to a diagnosis of cancer in providing any needed chemotherapy,
radiation, or diagnostic radiology services to such patients. Each cancer care
center shall report annually to the Department of Medical Assistance Services
regarding indigent care provided in accordance with this provision. ]
"Project" means:
1. Establishment of a medical care facility;
2. An increase in the total number of beds or operating rooms in an existing medical care facility;
3. Relocation at the same site of ten beds or ten percent of the beds, whichever is less, from one existing physical facility to another in any two-year period; however, a hospital shall not be required to obtain a certificate for the use of ten percent of its beds as nursing home beds as provided in § 32.1-132;
4. Introduction into an existing medical care facility of any new nursing home service, such as intermediate care facility services, extended care facility services, or skilled nursing facility services, regardless of the type of medical care facility in which those services are provided;
5. Introduction into an existing medical care facility of any new cardiac catheterization, computed tomographic (CT) scanning, gamma knife surgery, lithotripsy, magnetic resonance imaging (MRI), magnetic source imaging (MSI), medical rehabilitation, neonatal special care, obstetrical, open heart surgery, positron emission tomographic (PET) scanning, psychiatric, organ or tissue transplant service, radiation therapy, nuclear medicine imaging, substance abuse treatment, or such other specialty clinical services as may be designated by the Board by regulation, which the facility has never provided or has not provided in the previous twelve months;
6. Conversion of beds in an existing medical care facility to medical rehabilitation beds or psychiatric beds;
7. The addition by an existing medical care facility of any medical equipment for the provision of cardiac catheterization, computed tomographic (CT) scanning, gamma knife surgery, lithotripsy, magnetic resonance imaging (MRI), magnetic source imaging (MSI), open heart surgery, positron emission tomographic (PET) scanning, radiation therapy, or other specialized service designated by the Board by regulation. Replacement of existing equipment shall not require a certificate of public need; or
8. Any capital expenditure of five million dollars or more, not defined as reviewable in subdivisions 1 through 7 of this definition, by or in behalf of a medical care facility. However, capital expenditures between one and five million dollars shall be registered with the Commissioner pursuant to regulations developed by the Board.
"Regional health planning agency" means the regional agency, including the regional health planning board, its staff and any component thereof, designated by the Virginia Health Planning Board to perform the health planning activities set forth in this chapter within a health planning region.
"State Medical Facilities Plan" means the planning document adopted by the Board of Health which shall include, but not be limited to, (i) methodologies for projecting need for medical care facility beds and services; (ii) statistical information on the availability of medical care facilities and services; and (iii) procedures, criteria and standards for review of applications for projects for medical care facilities and services.
"Virginia Health Planning Board" means the statewide health planning body established pursuant to § 32.1-122.02 which serves as the analytical and technical resource to the Secretary of Health and Human Resources in matters requiring health analysis and planning.