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2020 SESSION

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Senate Committee on Education and Health
Subcommittee Certificate of Public Need

Lucas (Chair), Saslaw, Newman, Petersen, Barker, Cosgrove, Dunnavant

Clerk: Patty Lung, Catherine Dent
Staff: Julia Carlton, Anna Moir
Date of Meeting: February 4, 2020
Time and Place: Upon Adj. of Health Sub., Subcommittee Room 2, Pocahontas Bldg.

S.B. 279

Patron: Barker

Certificate of public need; criteria for determining need. Makes clear that in determining whether a public need for a proposed project has been demonstrated the State Health Commissioner shall consider the impact of the proposed project on all people to whom services may be provided and not only residents of the service area.

S.B. 330

Patron: Deeds

Certificate of public need; psychiatric beds and facilities. Removes mental hospitals and psychiatric hospitals and intermediate care facilities established primarily for the medical, psychiatric, or psychological treatment and rehabilitation of individuals with substance abuse from the list of medical care facilities for which a certificate of public need is required prior to initiation of a project. The bill makes clear that only facilities licensed as hospitals by the Department of Health are subject to certificate of public need requirements; removes from the definition of project the addition of a new psychiatric or substance abuse treatment service and conversion of beds in an existing medical care facility to psychiatric beds; and prohibits the conversion in an existing medical care facility of psychiatric beds to non-psychiatric beds.

S.B. 413

Patron: Cosgrove

Certificate of public need; determination of need. Provides that, for the purpose of determining public need for a proposed project in cases in which a provider or affiliated group of providers holds a market share of 55 percent or more for a type of service or medical care facility in a planning district, a proposed project involving the same type of service or medical care facility in the same planning district shall be presumed to be a project that fosters institutional competition that benefits the area to be served while improving access to essential health care services for all persons in the area to be served, absent evidence to the contrary. The bill also provides that, for the purpose of determining public need for a proposed project in cases in which a provider or affiliated group of providers holds a market share of 85 percent or more, the proposed project shall be deemed to be a project that fosters institutional competition that benefits the area to be served while improving access to essential health care services for all persons in the area to be served.

S.B. 503

Patron: Petersen

Certificate of public need; conditions; civil penalty. Defines "COPN-conditioned community care" as charity care provided to indigent persons and health care services to individuals eligible for benefits under Title XIX of the Social Security Act, 42 U.S.C § 1396 et seq. and (i) requires the Commissioner of Health to condition a certificate of public need on the agreement of the applicant to provide a level of community care to patients in the applicant's service area and establish the total amount of community care necessary to satisfy the condition; (ii) provides for imposition of a civil penalty of up to $100 per violation per day for failure to satisfy the conditions on a certificate of public need, but requires the Department of Health to waive the penalty in cases in which the certificate holder demonstrates, in accordance with regulations of the Board, that good faith efforts were made to comply with the conditions on a certificate but that the certificate holder was unable to satisfy the conditions of the certificate despite such good faith efforts; (iii) requires every certificate holder to develop a financial assistance policy that includes specific eligibility criteria and procedures for applying for charity care, which shall be provided to a patient at the time of admission or discharge or at the time services are provided, included with any billing statements sent to a patient, posted conspicuously in public areas of the medical care facility for which the certificate was issued, and posted on a website maintained by the certificate holder; and (iv) provides that when determining whether conditions imposed on a certificate of public need should be amended in response to a request submitted by the certificate holder, the Commissioner shall consider any changes in the circumstances of the certificate holder resulting from changes in the financing or delivery of health care services, including changes to the Commonwealth's program of medical assistance services, and any other specific circumstances of the certificate holder.

The bill also requires the Department of Health to establish an expedited review for certain projects involving addition of imaging equipment, addition of a new ambulatory or outpatient surgery center, addition of operating rooms at an existing ambulatory or outpatient surgery center, and addition of psychiatric beds or conversion of existing beds at a medical care facility to psychiatric beds and requires the Board of Health to include in regulations governing the certificate of public need program a provision for the development of review criteria and standards for specific medical care facilities and health care services for each health planning region that take into account the unique needs and characteristics of such region.

 

 

S.B. 523

Patron: McDougle

Certificates of public need; civil penalty. Exempts specialized centers or clinics or that portion of a doctor's office established for the provision of ambulatory or outpatient ophthalmic, urologic, or endoscopic surgery from the definition of medical care facility and creates a new permitting process for projects involving specialized centers or clinics or that portion of a doctor's office established for the provision of ophthalmic, urologic, or endoscopic surgery and services, subject to a civil penalty for failure or refusal to comply with certain conditions of the permit.

S.B. 764

Patron: Barker

Certificate of public need. Revises the Medical Care Facilities Certificate of Public Need Program. The bill (i) removes from the list of reviewable medical care facilities specialized centers or clinics or that portion of a physician's office developed for the provision of lithotripsy, magnetic source imaging, or nuclear medicine imaging; (ii) removes from the definition of project introduction into an existing medical care facility of any new lithotripsy, magnetic source imaging, or obstetrical service that the facility has never provided or has not provided in the previous 12 months and addition by an existing medical care facility of any medical equipment for the provision of lithotripsy and magnetic source imaging; (iii) creates a new process for registration of projects exempted from the definition of project by the bill; (iv) renames the State Medical Facilities Plan as the State Health Services Plan and establishes a State Health Services Plan task force to provide recommendations related to the content of the State Health Services Plan; (v) clarifies the content of the application for a certificate; (vi) reduces the timeline for a person to be made party to the case for good cause from 80 calendar days to four days following completion of the review and submission of recommendations related to an application; (vii) requires the Commissioner of Health to condition issuance of a certificate upon the agreement of the applicant to provide care to individuals who are eligible for benefits under Title XVIII of the Social Security Act (42 U.S.C. § 1395 et seq.), Title XIX of the Social Security Act (42 U.S.C. § 1396 et seq.), and 10 U.S.C. § 1071 et seq. and permits the Commissioner to condition the issuance of a certificate on the agreement of the applicant to provide specialty medical services or to pay assessments or make contributions into the Health Care Coverage Assessment Fund, in addition to existing options for conditioning certificates; (viii) requires every certificate holder to develop a financial assistance policy that includes specific eligibility criteria and procedures for applying for charity care, which shall be provided to a patient at the time of admission or discharge or at the time services are provided, included with any billing statements sent to uninsured patients, posted conspicuously in public areas of the medical care facility for which the certificate was issued and posted on a website maintained by the certificate holder; (ix) eliminates that a person willfully fail, refuse, or neglect to comply with a plan of correction to be subject to a civil penalty so that any failure, refusal, or neglecting to comply with a plan of correction may subject the person to a civil penalty; and (x) provides that the Commissioner may consider any changes in the circumstances of the certificate holder resulting from changes in the financing or delivery of health care services, including changes to the Commonwealth's program of medical assistance services, and any other specific circumstances of the certificate holder when determining whether conditions imposed on a certificate continue to be appropriate.

The bill also (a) directs the Department of Health to develop recommendations to reduce the duration of the average review cycle for applications for certificates of public need to not more than 120 days and to report on its recommendations to the Governor and the General Assembly no later than December 1, 2020, and (b) directs the Secretary of Health and Human Resources to implement a system to ensure that data needed to evaluate whether an application for a certificate is consistent with the State Health Services Plan is timely and reliable; to make all public records pertaining to applications for certificates and the review process available in real time in a searchable, digital format online; to make an inventory of capacity authorized by certificates of public need, both operational and not yet operational, available in a digital format online; and to establish a public education and outreach program designed to improve public awareness of the certificate of public need process and the public's role in such process by January 1, 2021.

 

S.B. 983

Patron: Lucas

Certificate of public need; definition of "medical care facility." Adds to the list of medical care facilities for which a certificate of public need is required any facility that has common ownership with an affiliated licensed hospital located within 35 miles of the facility and that includes, as part of the facility, a dedicated emergency department as defined in 42 C.F.R. § 489.24(b) that is subject to the requirements of the federal Emergency Medical Treatment and Active Labor Act.

S.B. 1081

Patron: Suetterlein

COPN; demonstration of public need and compliance with State Medical Facilities Plan. Provides that, notwithstanding any other provision of law or regulation, an application for a certificate of public need for the introduction of a specialty-level neonatal special care service in Planning District 5 that (i) contains in the record testimony of a neonatologist, employed or contracted by an incumbent provider of neonatal special care services in the same planning district, that the proposed number of bassinets in the application is clinically appropriate for the neonatal special care service proposed and would be beneficial to health outcomes of infants born at the applicant's facility and (ii) includes the agreement of the applicant to accept standard charity care conditions on the proposed neonatal special care services shall be deemed to (a) demonstrate a public need for such proposed specialty-level neonatal special care service and (b) be consistent with the State Medical Facilities Plan.