reglab/statecodes huggingface dataset:
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part V - Standard Review Process › Section 12VAC5-220-220 - Consideration of applications

Current through Register Vol. 40, No. 24, July 15, 2024
Applications for the same or similar services which are
					 proposed for the same planning district or medical service area shall be
					 considered as competing applications by the commissioner. The commissioner
					 shall determine whether an application is competing and shall provide written
					 notification to the competing applicants and the regional health planning
					 agency. The commissioner may, upon the request of an applicant, waive the
					 review schedule requirements of
					 12VAC5-220-200 in the case of a
					 documented emergency or in cases where, as of the deadline for filing a letter
					 of intent for the otherwise applicable cycle, there are no competing
					 applicants, and the applicant who has filed a letter of intent for a particular
					 project proposes to combine the intended project with another related project
					 for which an application will be filed in a subsequent batch
					 group.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part V - Standard Review Process › Section 12VAC5-220-240 - Participation by other persons

Current through Register Vol. 40, No. 24, July 15, 2024
Any person affected by a proposed project under review may
					 directly submit written opinions, data and other information to the appropriate
					 regional health planning agency and the commissioner for consideration prior to
					 their final action.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part V - Standard Review Process › Section 12VAC5-220-250 - Amendment to an application

Current through Register Vol. 40, No. 24, July 15, 2024
The applicant shall have the right to amend an application
					 at any time. Any amendment which is made to an application following the public
					 hearing and prior to the issuance of a certificate unless otherwise specified
					 in this chapter shall constitute a new application and shall be subject to the
					 review requirements set forth in Part V of this chapter. If such amendment is
					 made subsequent to the issuance of a certificate of public need, it shall be
					 reviewed in accordance with
					 12VAC5-220-130.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part V - Standard Review Process › Section 12VAC5-220-260 - Withdrawal of an application

Current through Register Vol. 40, No. 24, July 15, 2024
The applicant shall have the right to withdraw an
					 application from consideration at any time, without prejudice by written
					 notification to the commissioner.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VI - Expedited Review Process › Section 12VAC5-220-280 - Applicability

Current through Register Vol. 40, No. 24, July 15, 2024
Capital expenditures as contained in subdivision 8 of
					 "project" as defined in § 32.1-102.1 of the Code of Virginia or projects
					 that involve relocation at the same site of 10 beds or 10% of the beds,
					 whichever is less, from one existing physical facility to another, when the
					 cost of such relocation is less than $5 million, shall be subject to an
					 expedited review process.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VI - Expedited Review Process › Section 12VAC5-220-290 - Application forms

Current through Register Vol. 40, No. 24, July 15, 2024
A. Obtaining
				  application forms. Application forms for an expedited review shall be available
				  from the department upon the request of the applicant. The department shall
				  transmit application forms to the applicant within seven days of receipt of
				  such request.
B. Application fees.
				  The department shall collect application fees for applications that request a
				  certificate of public need under the expedited review process. No application
				  will be reviewed until the required application fee is paid as provided in
				  12VAC5-220-180 B.
C. Filing application forms. All requests for
				  a certificate of public need in accordance with the expedited review process
				  shall be reviewed by the department and the regional health planning agency
				  which shall each forward a recommendation to the commissioner within 40 days
				  from the date the submitted application has been deemed complete. No
				  application for expedited review shall be reviewed until the application form
				  has been received by the department and the appropriate regional health
				  planning agency, has been deemed complete, and the application fee has been
				  paid to the department.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VI - Expedited Review Process › Section 12VAC5-220-300 - Participation by other persons

Current through Register Vol. 40, No. 24, July 15, 2024
Any person directly affected by the review of a project
					 under the expedited review process may submit written opinions, data and other
					 information to the appropriate regional health planning agency and to the
					 commissioner prior to their final action.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VI - Expedited Review Process › Section 12VAC5-220-310 - Action on application

Current through Register Vol. 40, No. 24, July 15, 2024
A.
				  Decisions to approve any project under the expedited review process shall be
				  rendered by the commissioner within 45 days of the receipt of such completed
				  request. The commissioner shall approve and issue a certificate for any project
				  which is determined to meet the criteria for expedited review set forth in
				  12VAC5-220-280.
B. If the commissioner determines that a
				  project does not meet the criteria for an expedited review set forth in
				  12VAC5-220-280, the applicant will
				  be notified in writing of such determination within 45 days of the receipt of
				  such request. In such cases, the department will forward the appropriate forms
				  to the project applicant for use in filing an application for review of a
				  project in the appropriate review cycle in accordance with Part V of this
				  chapter.
C. Any project which does
				  not qualify for an expedited review in accordance with
				  12VAC5-220-280, as determined by
				  the commissioner, shall be exempted from the requirements of
				  12VAC5-220-180 A and B when such
				  project is filed for consideration in accordance with Part V of this
				  chapter.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VII - New Nursing Home Bed Review Process › Section 12VAC5-220-325 - Applicability

Current through Register Vol. 40, No. 24, July 15, 2024
The following categories of projects as determined by the
					 State Health Commissioner shall be subject to the nursing home bed review
					 process when they involve an increase in the number of nursing home facility
					 beds in Virginia. (For Continuing Care Retirement Community nursing home beds,
					 see Part V (12VAC5-220-170 et seq.) of this
					 chapter.)
1. The establishment of a
				  nursing home, intermediate care facility, or extended care facility, except
				  when such nursing home, intermediate care facility, or extended care facility
				  is proposed by a continuing care retirement community and the project is
				  sponsored by a continuing care provider registered with the State Corporation
				  Commission pursuant to Chapter 49 (§ 38.2-4900 et seq.) of Title 38.2 of
				  the Code of Virginia.
2. An
				  increase in the total number of beds in an existing or authorized nursing home,
				  intermediate care facility, or extended care facility, except when the nursing
				  home, intermediate care facility, or extended care facility is a component of a
				  continuing care retirement community and the project is sponsored by a
				  continuing care provider registered with the State Corporation Commission
				  pursuant to Chapter 49 (§ 38.2-4900 et seq.) of Title 38.2 of the Code of
				  Virginia.
3. An increase in the
				  total number of nursing home beds, intermediate care facility beds, or extended
				  care facility beds in an existing or authorized medical care facility which is
				  not a dedicated nursing home, intermediate care facility, or extended care
				  facility.
4. The introduction into
				  any 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 except when such medical care facility is an existing
				  nursing home as defined in § 32.1-123 of the Code of Virginia.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VII - New Nursing Home Bed Review Process › Section 12VAC5-220-335 - Request for Applications (RFA)

Current through Register Vol. 40, No. 24, July 15, 2024
Pursuant to § 32.1-102.3:2A, B, and C of the Code of
					 Virginia, the commissioner shall periodically issue a Request for Applications
					 (RFA). An RFA shall be issued at least annually.
A RFA from project applicants proposing projects which
					 would result in an increase in the number of beds are provided shall be based
					 on analyses of the need for increases in the bed supply in each of Virginia's
					 planning districts in accordance with the applicable standards included in the
					 State Medical Facilities Plan. Such RFAs shall also include a schedule for the
					 review of applications submitted in response to the RFA which allows for at
					 least 120 days between the day on which the RFA is issued and the first day of
					 the review cycle for such applications.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VII - New Nursing Home Bed Review Process › Section 12VAC5-220-345 - Limitation on acceptance of RFA applications

Current through Register Vol. 40, No. 24, July 15, 2024
Applications for projects listed in § 32.1-102.3:2A,
					 B, and C of the Code of Virginia shall only be accepted for review when
					 properly filed in response to a RFA. Furthermore, the commissioner shall only
					 accept for review applications which propose projects located in the planning
					 districts from which applications are requested in the RFA and propose
					 authorization of a number of new beds are provided which is less than or equal
					 to the total number of beds identified as needed for the planning district in
					 which the project will be located.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VII - New Nursing Home Bed Review Process › Section 12VAC5-220-355 - RFA project application forms

Current through Register Vol. 40, No. 24, July 15, 2024
A. Letter of intent. An RFA project applicant
				  shall file a letter of intent with the commissioner to request appropriate
				  application forms, and submit a copy of that letter to the appropriate regional
				  health planning agency by the letter of intent deadline specified in the RFA.
				  The letter shall identify the owner, the type of project for which an
				  application is requested, and the proposed scope (size) and location of the
				  proposed project. The department shall transmit application forms to the
				  applicant within seven days of the receipt of the letter of intent. A letter of
				  intent filed with the department shall be considered void if an application is
				  not filed for the project by the application deadline specified in the
				  RFA.
B. Application fees. The
				  department shall collect application fees for RFA applications that request a
				  certificate of public need. The applicant shall pay the fee prescribed by
				  subsection B of 12VAC5-220-95. No application will be deemed to be complete for
				  review until the required application fee is paid.
C. Filing application forms. Applications
				  must be submitted to the department and the appropriate regional health
				  planning agency by the application filing deadline specified in the RFA. In
				  order to verify the department and the appropriate regional health planning
				  agency's receipt of the application, the applicant shall transmit the document
				  electronically, or prepare in triplicate two copies to be submitted to the
				  department and one copy to be submitted to the appropriate regional health
				  planning agency and sent by certified mail or a delivery service, return
				  receipt requested, or by hand, with a signed receipt to be provided. No
				  application shall be deemed to have been submitted until required copies have
				  been received by the department and the appropriate regional health planning
				  agency.
Statutory Authority: §§ 32.1-12 and 32.1-102.2
						of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VII - New Nursing Home Bed Review Process › Section 12VAC5-220-365 - Review for completeness

Current through Register Vol. 40, No. 24, July 15, 2024
The applicant shall be notified by the department within
					 15 days following receipt of the application if additional information is
					 required to complete the application or the application is complete as
					 submitted. No application shall be reviewed until the department has determined
					 that it is complete. To be complete, all questions and information items
					 requested on the application must be completely addressed and the application
					 fee submitted. Additional information required to complete an application shall
					 be submitted to the department and the appropriate regional health planning
					 agency at least five days prior to the first day of the review cycle, as
					 specified in the RFA, to be considered in the review cycle.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VII - New Nursing Home Bed Review Process › Section 12VAC5-220-375 - Consideration of RFA applications

Current through Register Vol. 40, No. 24, July 15, 2024
RFA applications proposed for the same planning district
					 shall be considered as competing applications by the commissioner. The
					 commissioner shall determine whether an application is competing and provide
					 written notification to the competing applicants and the regional health
					 planning agency.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VII - New Nursing Home Bed Review Process › Section 12VAC5-220-395 - Participation by other persons

Current through Register Vol. 40, No. 24, July 15, 2024
Any person affected by a proposed project under review may
					 directly submit written opinions, data and other information to the appropriate
					 regional health planning agency and the commissioner for consideration prior to
					 their final action.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VII - New Nursing Home Bed Review Process › Section 12VAC5-220-405 - Amendment to an application

Current through Register Vol. 40, No. 24, July 15, 2024
The applicant shall have the right to amend an application
					 at any time. Any amendment which is made to an application following the public
					 hearing and prior to the issuance of a certificate unless otherwise specified
					 in this chapter shall constitute a new application and shall be subject to the
					 review requirements set forth in this part of this chapter. If such amendment
					 is made subsequent to the issuance of a certificate of public need, it shall be
					 reviewed in accordance with
					 12VAC5-220-130.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VII - New Nursing Home Bed Review Process › Section 12VAC5-220-410 - Withdrawal of an application

Current through Register Vol. 40, No. 24, July 15, 2024
The applicant shall have the right to withdraw an
					 application from consideration at any time without prejudice by written
					 notification to the commissioner.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VIII - Duration, Extension, and Revocation of Certificates › Section 12VAC5-220-430 - Duration

Current through Register Vol. 40, No. 24, July 15, 2024
A certificate of public need shall be valid for a period of
					 12 months and shall not be transferrable from the certificate holder to any
					 other legal entity regardless of the relationship, under any
					 circumstances.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VIII - Duration, Extension, and Revocation of Certificates › Section 12VAC5-220-440 - Extension

Current through Register Vol. 40, No. 24, July 15, 2024
A certificate of public need is valid for a 12-month
					 period and may be extended by the commissioner for additional time periods
					 which shall be specified at the time of the extension.
A. Basis for certificate extension within 24
				  months. An extension of a certificate of public need beyond the expiration date
				  may be granted by the commissioner by submission of evidence to demonstrate
				  that progress is being made towards the completion of the authorized project as
				  defined in
				  12VAC5-220-450. Such request shall
				  be submitted to the commissioner in writing with a copy to the appropriate
				  regional health planning agency at least 30 days prior to the expiration date
				  of the certificate or period of extension.
B. Basis for certificate extension beyond 24
				  months. An extension of a certificate of public need beyond the two years
				  following the date of issuance may be granted by the commissioner when
				  substantial and continuing progress is being made towards the development of
				  the authorized project. In making the determination, the commissioner shall
				  consider whether:
(i) any delays in
				  development of the project have been caused by events beyond the control of the
				  owner;
(ii) substantial delays in
				  development of the project may not be attributed to the owner; and
(iii) a schedule of completion has been
				  provided and determined to be reasonable. Such request shall be submitted in
				  writing with a copy to the appropriate regional health planning agency at least
				  30 days prior to the expiration date of the certificate of period of extension.
				  The commissioner shall not grant an extension to the schedule for completion of
				  a project beyond three years (36 months) of the date of certificate issuance or
				  beyond the time period approved at the date of certificate issuance, whichever
				  is greater, unless such extension is authorized in accordance with the
				  provisions for a significant change. See
				  12VAC5-220-130, Significant change
				  limitation.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VIII - Duration, Extension, and Revocation of Certificates › Section 12VAC5-220-450 - Demonstration of progress

Current through Register Vol. 40, No. 24, July 15, 2024
The applicant shall provide reports to demonstrate
					 progress made towards the implementation of an authorized project in accordance
					 with the schedule of development which shall be included in the application.
					 Such progress reports shall be filed in accordance with the following intervals
					 and contain such evidence as prescribed at each interval:
A. Twelve months following issuance.
				  Documentation that shows:
(i) proof of
				  ownership or control of site;
(ii)
				  the site meets all zoning and land use requirements;
(iii) architectural planning has been
				  initiated;
(iv) preliminary
				  architectural drawings and working drawings have been submitted to appropriate
				  state reviewing agencies and the State Fire Marshal;
(v) construction financing has been completed
				  or will be completed within two months and
(vi) purchase orders or lease agreements
				  exist for equipment and new service projects.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part VIII - Duration, Extension, and Revocation of Certificates › Section 12VAC5-220-460 - Revocation of certificate

Current through Register Vol. 40, No. 24, July 15, 2024
A. Lack
				  of progress. Failure of any project to meet the progress requirements stated in
				  12VAC5-220-450 shall be cause for
				  certificate revocation, unless the commissioner determines sufficient
				  justification exists to permit variance, considering factors enumerated in
				  12VAC5-220-450.
B. Failure to report progress. Failure of an
				  applicant to file progress reports on an approved project in accordance with
				  12VAC5-220-450 shall be cause for
				  revocation, unless, due to extenuating circumstances, the commissioner, in his
				  sole discretion, extends the certificate, in accordance with subsection B of
				  12VAC5-220-440.
C. Unapproved changes. Exceeding a capital
				  expenditure amount not authorized by the commissioner or not consistent with
				  the schedule of completion shall be cause for revocation. See definition of
				  "significant change" and "schedule of completion."
D. Failure to initiate construction. Failure
				  to initiate construction of the project within two years following the date of
				  issuance of the certificate of public need shall be cause for revocation,
				  unless due to extenuating circumstances the commissioner extends the
				  certificate, in accordance with subsection B of
				  12VAC5-220-440.
E. Misrepresentation. Upon determination that
				  an applicant has knowingly misrepresented or knowingly withheld relevant data
				  or information prior to issuance of a certificate of public need, the
				  commissioner may revoke said certificate.
F. Noncompliance with assurances. Failure to
				  comply with the assurances or intentions set forth in the application or
				  written assurances provided at the time of issuance of a certificate of public
				  need shall be cause for revocation.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part IX - Appeals › Section 12VAC5-220-470 - Judicial review

Current through Register Vol. 40, No. 24, July 15, 2024
Appeals to a circuit court shall be governed by the
					 Virginia Administrative Process Act, § 2.2-4000 et seq. of the Code of
					 Virginia, and Part Two A of the Rules of the Supreme Court of
					 Virginia.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part X - Sanctions › Section 12VAC5-220-480 - Violation of rules and regulations

Current through Register Vol. 40, No. 24, July 15, 2024
Commencing any project without a certificate required by
					 this chapter shall constitute grounds for refusing to issue a license for such
					 project.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part X - Sanctions › Section 12VAC5-220-490 - Injunctive relief

Current through Register Vol. 40, No. 24, July 15, 2024
On petition of the commissioner, the Board of Health or the
					 Attorney General, the circuit court of the county or city where a project is
					 under construction or is intended to be constructed, located or undertaken
					 shall have jurisdiction to enjoin any project which is constructed, undertaken
					 or commenced without a certificate or to enjoin the admission of patients to
					 the project or to enjoin the provision of services through the
					 project.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part X - Sanctions › Form - FORMS (12VAC5-220)

Current through Register Vol. 40, No. 24, July 15, 2024
Application for Expedited Review for Certificate of Public
					 Need (eff. 6/94).
Registration Form for Capital Expenditures of $1,000,000 or
					 More But Less than $2,000,000 Which are Not Defined as a Project on or After
					 July 1, 1993.
Request for Extension of a Certificate of Public Need
					 Beyond Two Years from Date of Issuance.
Request for Extension of a Certificate of Public Need
					 Beyond One Year, But Less then Two Years from Date of Issuance (Rev.
					 7/26/93).
Application for a Medical Care Facilities Certificate of
					 Public Need - Outpatient Facilities (Rev. 12/10/92).
Application for a Medical Care Facilities Certificate of
					 Public Need - Hospitals (Rev. 12/10/92).
Application for a Medical Care Facilities Certificate of
					 Public Need - Long-Term Care Facilities (Rev. 10/2007).
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 221 - REGULATIONS GOVERNING COOPERATIVE AGREEMENTS › Section 12VAC5-221-20 - Separate applications

Current through Register Vol. 40, No. 24, July 15, 2024
A party shall submit an application for a letter authorizing
				  cooperative agreement for each cooperative agreement the party is applying to
				  enter into. This provision applies even in the event that the parties have an
				  existing letter authorizing cooperative agreement issued by the commissioner.
				  An amendment to a cooperative agreement shall require submission of a new
				  application.
Statutory Authority: §
											32.1-12 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 221 - REGULATIONS GOVERNING COOPERATIVE AGREEMENTS › Section 12VAC5-221-30 - Application

Current through Register Vol. 40, No. 24, July 15, 2024
A. Parties within
				any participating locality may submit an application for a letter authorizing
				cooperative agreement to the authority. Information regarding the requirements
				of an application for a letter authorizing cooperative agreement submitted to
				the authority should be obtained through the authority.
B. At the time of submission to the
				authority, parties shall simultaneously submit a copy of the application to the
				commissioner and the Attorney General.
C. If the authority requires the applicant to
				submit additional information before determining that the application is
				complete, the parties shall simultaneously submit a copy of the additional
				information to the authority, the commissioner, and the Attorney
				General.
D. If the applicants
				believe the materials submitted contain proprietary information that is
				required to remain confidential, such information must be clearly identified
				and the applicants shall submit duplicate applications, one with full
				information for the commissioner's use and one redacted application available
				for release to the public. Proprietary information that is clearly identified
				by the applicants will be kept confidential by the department pursuant to
				subdivision 3 of §
									2.2-3705.6 of the Code of
				Virginia.
Statutory Authority: §
											32.1-12 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 221 - REGULATIONS GOVERNING COOPERATIVE AGREEMENTS › Section 12VAC5-221-50 - Public hearing

Current through Register Vol. 40, No. 24, July 15, 2024
A. The
				authority shall, in conjunction with the commissioner, schedule a public
				hearing for each completed application submitted. The hearing shall be held no
				later than 45 days after the receipt of a complete application by the
				authority.
B. The authority will
				publish and issue notice of the hearing in accordance with subsection C of
				§
									15.2-5384.1 of the Code of
				Virginia.
C. The public hearing
				shall be open to the public in accordance with the provisions of the Virginia
				Freedom of Information Act (§
									2.2-3700 et seq. of the Code of
				Virginia).
D. The public hearing
				shall be recorded by the Virginia Department of Health.
Statutory Authority: §
											32.1-12 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 221 - REGULATIONS GOVERNING COOPERATIVE AGREEMENTS › Section 12VAC5-221-60 - Public comment to the commissioner

Current through Register Vol. 40, No. 24, July 15, 2024
The public may submit written comments regarding the
				  application to the commissioner. To ensure consideration by the commissioner,
				  written comments must be received no later than 14 days after the authority
				  adopts its recommendation on the application.
Statutory Authority: §
											32.1-12 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 221 - REGULATIONS GOVERNING COOPERATIVE AGREEMENTS › Section 12VAC5-221-70 - Commissioner's request for information

Current through Register Vol. 40, No. 24, July 15, 2024
A. Upon receipt of the authority's
				recommendation for approval, the commissioner and department may request
				supplemental information from the applicants.
B. To the extent the information is not
				present within the application, the commissioner shall request the following
				information:
1. A report or reports used for
				public information and education about the proposed cooperative agreement prior
				to the parties' submission of the application. The applicants shall document
				the efforts used to disseminate the report or reports. The report or reports
				shall include:
a. A description of the
				proposed primary service area (PSA) and secondary service areas (SSA) and the
				services and facilities to be included in the cooperative agreement;
b. A description of how health services will
				change if the letter authorizing cooperative agreement is issued;
c. A description of improvements in patient
				access to health care including prevention services for all categories of
				payers and advantages patients will experience across the entire service area
				regarding costs, availability, and accessibility upon implementation of the
				cooperative agreement or findings from studies conducted by hospitals and other
				external entities, including health economists, and clinical services and
				population health experts, that describe how implementation of the proposed
				cooperative agreement will be effective with respect to resource allocation
				implications; efficient with respect to fostering cost containment, including
				eliminating duplicative services; and equitable with respect to maintaining
				quality and competition in health services within the service area and assuring
				patient access to and choice of insurers and providers within the health care
				system;
d. A description of any
				plans by the parties regarding existing or planned facilities that will impact
				access for patients to the services currently offered by the parties at their
				respective facilities, including expansions, closures, reductions in capacity,
				consolidation, and reduction or elimination of any services;
e. A description of the findings from
				community or population health assessments for the service areas regarding
				major health issues, trends, and health disparities, including comparisons to
				measures for the state and similar regional areas, and a description of how the
				health of the population will change if the letter authorizing cooperative
				agreement is issued; and
f. A
				description of the impact on the health professions workforce, including
				long-term employment, wage levels, retirement, benefits, recruitment, and
				retention of health professionals.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 221 - REGULATIONS GOVERNING COOPERATIVE AGREEMENTS › Section 12VAC5-221-80 - Commissioner's review

Current through Register Vol. 40, No. 24, July 15, 2024
A. The
				commissioner shall consult with the Attorney General when reviewing an
				application.
B. The commissioner
				may consult with the Federal Trade Commission when reviewing an
				application.
C. The commissioner
				may consult and coordinate with other affected jurisdictions when reviewing an
				application.
D. The commissioner
				shall consult with all other affected agencies of the Commonwealth when
				reviewing an application.
E. The
				commissioner in his review shall examine the record developed by the authority,
				the authority's recommendation for approval, and any additional information
				received from the parties. In addition, the commissioner may consider any other
				data, information, or advice available to him.
F. The commissioner shall not render a
				decision on the application until all supplemental information requested has
				been received.
G. The commissioner
				shall consider the following factors when conducting a review of an
				application:
1. Advantages.
a. Enhancement of the quality of hospital and
				hospital-related care, including mental health services and treatment of
				substance abuse, provided to citizens served by the authority, resulting in
				improved patient satisfaction;
b.
				Enhancement of population health status consistent with the regional health
				goals established by the authority;
c. Preservation of hospital facilities in
				geographical proximity to the communities traditionally served by those
				facilities to ensure access to care;
d. Gains in the cost-efficiency of services
				provided by the hospitals involved;
e. Improvements in the utilization of
				hospital resources and equipment;
f. Avoidance of duplication of hospital
				resources;
g. Participation in the
				state Medicaid program; and
h.
				Total cost of care.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 221 - REGULATIONS GOVERNING COOPERATIVE AGREEMENTS › Section 12VAC5-221-90 - Action on an application

Current through Register Vol. 40, No. 24, July 15, 2024
A. The
				commissioner shall issue his decision in writing within 45 days of receipt of
				the authority's recommendation. However, if the commissioner has requested
				supplemental information from the applicants, the commissioner shall have 15
				days, following receipt of the supplemental information, to issue a
				decision.
B. At the request of the
				applicants, the commissioner may delay issue of his decision to provide
				additional time to review the record.
C. The commissioner may condition approval of
				the letter authorizing cooperative agreement upon the applicants' commitment to
				achieving the improvements in population health, access to health care
				services, quality, and cost efficiencies identified by the applicants in
				support of their application. Such conditions may include:
1. A cap on the negotiated case-mix adjusted
				revenue per discharge by payer by product. The method for calculating such a
				case-mix shall be published on the Virginia Department of Health's Office of
				Licensure and Certification's website in a guidance document. The department
				may rely on third-party auditors to assist in determining the method for
				determining such caps, such caps' levels, and a plan for monitoring
				compliance;
2. A commitment to
				return a portion of the cost savings and efficiencies gained through the
				cooperative agreement to residents in the participating localities through
				specific proposed mechanisms;
3. An
				agreement that the parties shall not prevent or discourage health plans from
				directing or incentivizing patients to choose certain providers; the parties
				shall not have any contractual clauses or provisions that prevent health plans
				from directing or incentivizing patients;
4. An agreement that the parties shall not
				engage in the tying of sales of the health system's services with the health
				plan's purchase of other services from the health system;
5. An agreement that the parties shall not
				restrict a health plan's ability to make available to its health plan enrollees
				cost, quality, efficiency, and performance information to aid enrollees in
				evaluating and selecting providers in the health plan; and
6. A commitment that the parties shall not
				refuse to include certain provisions in contracts with health plans that have
				been utilized in health plan contracts in other parts of the Commonwealth in
				order to promote value-based health care, including bundled payments, pay for
				performance, utilization management, and other processes that reward
				improvements in quality and efficiency.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 221 - REGULATIONS GOVERNING COOPERATIVE AGREEMENTS › Section 12VAC5-221-100 - Ongoing and active supervision

Current through Register Vol. 40, No. 24, July 15, 2024
A. The commissioner shall maintain active and
				continuing supervision of the parties in accordance with the terms under this
				section and to ensure compliance with the cooperative agreement and the letter
				authorizing cooperative agreement.
B. Any party who receives a letter
				authorizing cooperative agreement shall submit any additional information that
				is requested by the department to establish benchmarks for ongoing monitoring
				and supervision. The department's request may include (i) information on
				patient satisfaction, (ii) information on employee satisfaction, (iii) a charge
				master, (iv) information reflecting the contracted rates negotiated with
				nonphysician providers, (v) information reflecting the noncontracted rates
				negotiated with allied health professionals, and (vi) information reflecting
				the noncontracted rates negotiated with other providers.
C. The department shall establish
				quantitative measures that will be used to evaluate the proposed and continuing
				benefits of the cooperative agreement.
1. The
				quantitative measures shall include measures of the cognizable benefits from
				the cooperative agreement in at least the following categories:
a. Population health;
b. Access to health services;
c. Economic;
d. Patient safety;
e. Patient satisfaction; and
f. Other cognizable benefits.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 221 - REGULATIONS GOVERNING COOPERATIVE AGREEMENTS › Section 12VAC5-221-110 - Annual reporting

Current through Register Vol. 40, No. 24, July 15, 2024
A. The
				parties shall report annually to the commissioner on the extent of the benefits
				realized and compliance with any terms and conditions placed on their letter
				authorizing cooperative agreement. The report shall:
1. Describe the activities conducted pursuant
				to the cooperative agreement;
2.
				Include any actions taken in furtherance of commitments made by the parties or
				terms imposed by the commissioner as a condition for approval of the
				cooperative agreement;
3. Include
				information related to changes in price, cost, quality, access to care, and
				population health improvement;
4.
				Include actual costs, revenues, profit margins, and operating costs;
5. Include a charge master;
6. Include information reflecting the
				contracted rates negotiated with nonphysician providers, allied health
				professionals, and others;
7.
				Include any measures requested by the department based on the recommendations
				of the technical advisory panel appointed pursuant to 12VAC5-221-120;
				and
8. Include the current status
				of the quantitative measures established under subsection C of 12VAC5-221-100
				and the information requested by the department for benchmarks established in
				subsection B of 12VAC5-221-100.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 221 - REGULATIONS GOVERNING COOPERATIVE AGREEMENTS › Section 12VAC5-221-120 - Technical advisory panel

Current through Register Vol. 40, No. 24, July 15, 2024
A. The
				commissioner shall appoint a technical advisory panel to provide (i) initial
				recommendations to the commissioner as to the quality, cost, and access
				measures and benchmarks to be considered to objectively track the benefits and
				disadvantages of a cooperative agreement and (ii) ongoing input to the
				commissioner on the evolution of these and other new measures and the progress
				of the parties with respect to achievement of commitments with respect to these
				measures.
B. The technical advisory
				panel shall consist of:
1. A representative
				of the Commissioner of Health who shall serve as chair of the panel;
2. The chief medical or quality officer or
				officers of the parties;
3. A chief
				medical or quality officer of a hospital or health system from other state
				market areas with no affiliation with the parties;
4. A chief medical or quality officer of a
				health plan that has subscribers in the affected area;
5. Experts in the area of health quality
				measurement and performance;
6. A
				consumer and employer representative from the affected area;
7. A representative from the Bureau of
				Insurance of the State Corporation Commission;
8. The chief financial officer or officers of
				the parties;
9. A chief financial
				officer of a hospital or health system from other state market areas with no
				affiliation with the parties; and
10. A chief financial officer of a health
				plan that has subscribers in the affected area.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 221 - REGULATIONS GOVERNING COOPERATIVE AGREEMENTS › Section 12VAC5-221-130 - Enforcement procedures

Current through Register Vol. 40, No. 24, July 15, 2024
A. If the
				commissioner has reason to believe that compliance with a cooperative agreement
				no longer meets the requirements of §
									15.2-5384.1 of the Code of
				Virginia or this chapter, the commissioner shall initiate a proceeding to
				determine whether compliance with the cooperative agreement no longer meets the
				requirements of §
									15.2-5384.1 of the Code of
				Virginia or this chapter.
B. In the
				course of such a proceeding, the commissioner is authorized to seek reasonable
				modifications to a letter authorizing cooperative agreement. Such modifications
				shall be with the consent of the parties.
C. The commissioner may revoke a letter
				authorizing cooperative agreement upon a finding that:
1. The parties are not complying with the
				terms or conditions of the cooperative agreement or the letter authorizing
				cooperative agreement;
2. The
				cooperative agreement is not in substantial compliance with the terms of the
				parties' application or the letter authorizing cooperative agreement;
3. The benefits resulting from the
				cooperative agreement no longer outweigh the disadvantages attributable to the
				reduction in competition resulting from the cooperative agreement;
4. The commissioner's approval was obtained
				as a result of intentional material misrepresentation to the commissioner or as
				the result of coercion, threats, or intimidation toward any party to the
				cooperative agreement; or
5. The
				parties have failed to pay any fee required by the department or the
				authority.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 221 - REGULATIONS GOVERNING COOPERATIVE AGREEMENTS › Section 12VAC5-221-140 - Voluntary termination of cooperative agreement

Current through Register Vol. 40, No. 24, July 15, 2024
A. Any party shall file notice with the
				department within 30 days after terminating its participation in a cooperative
				agreement. The notice shall be sent in writing to the attention of the director
				of the department's Office of Licensure and Certification.
B. In the event of a termination of a
				cooperative agreement, the parties shall return the letter authorizing
				cooperative agreement to the department's Office of Licensure and
				Certification.
Statutory Authority: §
											32.1-12 of the Code of
					 Virginia.