Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart D - Health Planning › Chapter 301 - LIMITATION ON FEDERAL PARTICIPATION FOR CAPITAL EXPENDITURES › Section 301.9 - Determination by the Secretary of HHS

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
				  This section issued by the Department of Health imposes no legal obligation on
				  the Secretary of HHS. It restates the Federal regulation found at
				  42 CFR
				  100.108 (relating to determination by the
				  Secretary). Reference should be made to the Federal regulation.
(b) Except as provided in subsection (c), if
				  the Secretary of HHS determines that the designated planning agency has not
				  been given timely notice of intention to make a capital expenditure in
				  accordance with §
										301.6 (relating to procedures for
				  agency review) or that the designated planning agency has, in accordance with
				  the requirements of section 1122 of the act (42 U.S.C.A. §
											1320a-1) and this chapter, submitted to the
				  Secretary of HHS its findings that the expenditure is not consistent with the
				  standards, criteria or plans described in §
										301.4(2)
				  (relating to designation; review of proposed capital expenditures) then for a
				  period the Secretary of HHS deems necessary to effectuate the purpose of
				  section 1122 of the act, the Secretary of HHS will, in determining the Federal
				  payments to be made under Titles V, XVIII and XIX of the act (42 U.S.C.A. §§
											701-709,
				  1395-1395zz and
				  1396-1396ff) to the health
				  care facility or health maintenance organization, exclude expenses related to
				  the capital expenditure.
(c)
				  Notwithstanding the provisions of subsection (b), if the Secretary of HHS,
				  after submitting the matters involved to the National Advisory Health Council
				  on Comprehensive Health Planning Programs and after taking into consideration
				  the recommendations of the designated planning agency and the other agency
				  described in §
										301.4(2)(i) with
				  respect to the expenditure, determines that an exclusion of expenses related to
				  a capital expenditure of a health care facility or health maintenance
				  organization would discourage the operation or expansion of the facility or
				  organization or of any facility of the organization which has demonstrated to
				  his satisfaction proof of capability to provide comprehensive health care
				  services efficiently, effectively and economically or would otherwise be
				  inconsistent with the effective organization and delivery of health services or
				  the effective administration of Titles V, XVIII or XIX of the act
				  (42 U.S.C.A. §§
											701-709,
				  1395-1395zz and
				  1396-1396ff), the
				  Secretary of HHS will include the expenses in Federal payments under such
				  titles.
(d) Upon making a
				  determination under this section, the Secretary of HHS will promptly notify the
				  person proposing a capital expenditure, the designated planning agency and the
				  other agency described in §
										301.4(2)(i) with
				  which the designated planning agency has consulted of the determination and the
				  basis for the determination.
(e) A
				  person dissatisfied with a determination by the Secretary of HHS under section
				  1122 of the act or this chapter with respect to a particular capital
				  expenditure may, within 6 months following the date of the determination,
				  request the Secretary of HHS to reconsider the determination.
(1) The request for reconsideration shall be
				  in writing, shall be addressed to the Secretary of HHS or to an officer or
				  employe of HHS to whom the Secretary of HHS has delegated responsibility to
				  receive requests, and shall set forth the grounds based upon the record of the
				  proceedings and issues of law upon which reconsideration is
				  requested.
(2) Reconsideration will
				  be based upon the record of the proceedings, which shall consist of the
				  findings; the recommendation and supporting materials submitted to the
				  Secretary of HHS by the designated planning agency, including the findings and
				  recommendations of other agencies, which relate to the findings and
				  recommendations involved; the record of the hearing provided by the designated
				  planning agency, if any, and of judicial proceedings; the materials submitted
				  in connection with the request; and the comments as the Secretary of HHS may
				  request from the designated planning agency.
(3) Notice of a reconsidered determination
				  under this subsection shall be sent to the designated planning agency and the
				  person requesting such reconsideration.