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2016 SESSION

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Senate Committee on Education and Health
Subcommittee Health Professions

Garrett (Chairman), Carrico, Barker, Dunnavant, Lucas, Suetterlein

Clerk: Patty Lung
Staff: Thomas Stevens, Ryan Brimmer
Date of Meeting: February 9, 2016
Time and Place: 8:30 AM - 4th Floor East

S.B. 333

Patron: DeSteph


Certificates of public need. Creates a three-phase process to sunset certificate of public need requirements for many categories of medical care facilities and projects, with the requirement for a certificate of public need (i) for the establishment of a new imaging service or addition of new equipment for imaging services eliminated beginning July 1, 2016, for ambulatory and outpatient surgery centers eliminated beginning July 1, 2017, and (iii) for hospitals and all other categories of projects other than nursing homes and facilities and equipment for open heart surgery and organ or tissue transplant services eliminated beginning July 1, 2018. The bill also creates a new permitting process for categories of facilities and projects exempted from the certificate of public need process that requires the Commissioner of Health to issue a permit but allows the Commissioner to condition a permit (a) on the agreement of the applicant to provide a specified level of care at a reduced rate to indigents, accept patients requiring specialized care, or facilitate the development and operation of primary medical care services in designated medically underserved areas of the applicant's service area or (b) on compliance of the applicant with quality of care standards. The bill allows the Commissioner to refuse to issue a permit if he determines that the project for which the permit is sought would be detrimental to the provision of health services in underserved areas of the Commonwealth.

 

S.B. 398

Patron: DeSteph

Certificates of public need; cataract surgery. Eliminates the requirement for a certificate of public need for the establishment of a new medical care facility for the provision of cataract surgery, the addition at an existing medical care facility of any new cataract surgery service, or the addition at any existing medical care facility of any new equipment for cataract surgery.

S.B. 561

Patron: Newman

Certificates of public need. Creates a three-phase process to sunset certificate of public need requirements for many categories of medical care facilities and projects, with the requirement for a certificate of public need (i) for the establishment of a new imaging service or addition of new equipment for imaging services eliminated beginning July 1, 2016, for ambulatory and outpatient surgery centers eliminated beginning July 1, 2017, and (iii) for hospitals and all other categories of projects other than nursing homes and facilities and equipment for open heart surgery and organ or tissue transplant services eliminated beginning July 1, 2018. The bill also creates a new permitting process for categories of facilities and projects exempted from the certificate of public need process that requires the Commissioner of Health to issue a permit but allows the Commissioner to condition a permit (a) on the agreement of the applicant to provide a specified level of care at a reduced rate to indigents, accept patients requiring specialized care, or facilitate the development and operation of primary medical care services in designated medically underserved areas of the applicant's service area or (b) on compliance of the applicant with quality of care standards. The bill allows the Commissioner to refuse to issue a permit if he determines that the project for which the permit is sought would be detrimental to the provision of health services in underserved areas of the Commonwealth.

 

S.B. 585

Patron: Barker

Certificates of public need; conditions. Authorizes the State Health Commissioner to condition the approval of a certificate of public need upon an agreement of the applicant to support charitable organizations specifically concerned with the provision of health care services to disabled veterans and that have a memorandum of understanding with the State Department of Health to meet specific unmet or partially unmet community health needs identified by the Department. The bill contains technical amendments.

S.B. 641

Patron: Stanley

Certificate of public need. Makes changes to the Medical Care Facilities Certificate of Public Need Program. The bill (i) removes specialized centers or clinics or that portion of a physician's office developed for the provision of lithotripsy, magnetic source imaging (MSI), or nuclear medicine imaging from the list of reviewable medical care facilities; (ii) provides that establishment of a medical care facility to replace an existing medical care facility with the same primary service area does not constitute a project; (iii) removes 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 (MSI) from the definition of project; (iv) creates a new process for registration of projects exempted from the definition of project by the bill; (v) establishes an expedited 45-day review process for applicants for projects determined to be uncontested or to present limited health planning impacts; (vi) renames the State Medical Facilities Plan as the State Health Services Plan and establishes a State Health Services Plan Advisory Council to provide recommendations related to the content of the State Health Services Plan; (vii) clarifies the content of the application for a certificate; and (viii) 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.

The bill also (a) directs the Department 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, 2016; (b) directs the Secretary of Health and Human Resources to review charity care services delivered throughout the Commonwealth and recommend changes to the definition of charity and to the types of charity care requirements imposed on various health care services and report to the Governor and the General Assembly by December 1, 2016; (c) directs the Secretary of Health and Human Resources to convene a group of stakeholders to study and make recommendations related to the appropriate authority of the State Health Commissioner to impose additional conditions on certificates; (d) 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 make charity care conditions, charity care compliance reporting status, and details on the exact amount of charity care provided or contributed and to whom it was provided or contributed available in a digital format online; (e) directs the Commissioner of Health to develop an analytical framework to guide the work of the State Health Services Plan Advisory Council; and (f) directs the Joint Commission on Health Care to develop specific recommendations for eliminating differences in the certificate of public need review process from one region to another and report on the recommendations to the Chairmen of the House Health, Welfare and Institutions and Senate Education and Health Committees by December 1, 2016.

 

S.B. 777

Patron: Barker

Certificate of public need program. Clarifies that the Certificate of Public Need program is established to address cost containment in the delivery of health care services, indigent care, and the health care needs of underserved populations; quality of care and patient safety; access to care; distribution of essential health care services; and support for the unique research, training, and clinical mission of teaching hospitals in the Commonwealth. The bill directs the Board of Health (the Board) to adopt regulations establishing concise procedures for evaluating emerging technologies and health care delivery models, equipment, and facility types to determine whether such technologies, models, equipment, or facility types should be subject to the requirement of a certificate of public need and provides that the Commissioner of Health (the Commissioner) may condition certificates on the agreement of the applicant to (i) participate in the Commonwealth's program of medical assistance and provide access to medical care services to individuals receiving medical assistance under the state plan for medical assistance services and (ii) establish and maintain a charity care policy to provide free and discounted care to indigent individuals. The bill requires the Commissioner to develop recommendations for guidelines for the uniform implementation of such conditions and report his recommendations to the Board by November 1, 2016.

The bill also requires the Commissioner to develop recommendations related to establishment of concise procedures for evaluating emerging technologies and health care delivery models, equipment, and facility types to determine whether such technologies, models, equipment, or facility types should be subject to the requirement of a certificate of public need and report such recommendations to the Board no later than November 1, 2016; requires the Board to adopt regulations establishing concise procedures for evaluating emerging technologies and health care delivery models, equipment, and facility types to determine whether such technologies, models, equipment, or facility types should be subject to the requirement of a certificate of public need by November 1, 2017; and requires the Commissioner to establish an advisory group composed of stakeholders to develop recommendations related to the role of regional health planning agencies in the certificate of public need process, and barriers to the continued role of regional health planning agencies in the certificate of public need process, and report such recommendations to the Board by October 1, 2016.