reglab/statecodes huggingface dataset:
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-28 - West Virginia Health Information Network Rule › Section 65-28-14 - Complaint Procedure

Current through Register Vol. XLI, No. 28, July 12, 2024
14.1 Any
				patient, authorized user, or participating organization, may file a written
				complaint with the Network concerning any aspect of its operations. All
				complaints shall be in writing and shall identify the individual responsible
				for making the complaint.
14.1.a. The Network
				shall develop and approve a complaint form which includes, at a minimum, the
				following items:
14.1.a.1. The name, address,
				and phone number of the individual making the complaint;
14.1.a.2. The date of the
				complaint;
14.1.a.3. The date that
				an adverse event occurred; and
14.1.a.4. A description of the adverse
				event.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-28 - West Virginia Health Information Network Rule › Section 65-28-15 - Pilot Demonstration Projects

Current through Register Vol. XLI, No. 28, July 12, 2024
15.1. The Network may develop, implement, and
				operate one or more pilot demonstration projects in designated communities of
				the state to acclimatize participating organizations to the health information
				exchange environment, and to evaluate the efficiency and effectiveness of its
				health information exchange system. The Network shall coordinate its pilot
				demonstration projects with diverse components of the health care delivery
				system in the communities chosen. The pilot demonstration projects shall be
				developed, implemented, and operated in full compliance with this
				rule.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-29 - Exemption From Certificate of Need › Section 65-29-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1.
				Scope. -This legislative rule establishes the general criteria and
				procedures for applying for an exemption from Certificate of Need.
1.2. Authority. -W. Va.
				Code §
									16-2D-4(a)(2), §
									16-2D-11 and §
									16-29B-8(a)(1).
1.3. Filing Date. -April
				29, 2021.
1.4. Effective
				Date. -April 30, 2021.
1.5 Sunset Date. -This rule shall
				terminate and have no further force or effect on August 1, 2026.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-29 - Exemption From Certificate of Need › Section 65-29-2 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
As used in this legislative rule, all terms that
				  are defined in W. Va. Code §
									16-2D-2 have those same meanings
				  which are in some cases further clarified in this rule. All terms not
				  defined in W. Va. Code §
									16-2D-2 have the following meanings
				  unless the context expressly requires otherwise.
2.1.a. "Authority" means the West
				Virginia Health Care Authority which is designated to administer the
				Certificate of Need program by W. Va. Code §
									16-2D-3(a)(1).
2.1.b. "Medically
				underserved population" is defined on a county-by-county basis.
				Applicants seeking an exemption for a proposed new end-stage renal
				disease treatment facility under this rule shall identify the service
				area as the county where the new facility is proposed to be located.
				For purposes of this rule only, a county service area with fewer than
				50,000 residents is deemed to be a medically underserved population
				if there is no kidney disease treatment center located less than six
				driving miles from the location provided in the exemption
				application.
2.1.c.
				"Statute" means the West Virginia Health Care Authority Certificate
				of Need statute, W. Va. Code §
									16-2D-1
et
				seq
.
2.1.d.
				"Verification" means a statement made under oath before a notary
				public that the information is knowingly provided and is true and
				correct.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-29 - Exemption From Certificate of Need › Section 65-29-3 - General Requirements

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. A health service exempt from
				certificate of need review by W.Va. Code §
									16-2D-11 may not be
				acquired, offered, or developed within this state unless notification
				of the performance of the exemption is provided to the Authority.
3.2. A person or health
				care facility may not knowingly charge or bill for a health service
				exempted from certificate of need review by W. Va. Code
				§
									16-2D-11 without first submitting a notification of performance
				of the exemption to the Authority.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-29 - Exemption From Certificate of Need › Section 65-29-4 - Application

Current through Register Vol. XLI, No. 28, July 12, 2024
An application for an exemption shall, at a
				  minimum, include the following:
4.1.a. Name, address, and contact
				information for the applicant;
4.1.b. Name, address, and contact
				information for the person making the application;
4.1.c. Verifications from the
				person making the application and the CEO of the applicant entity;
4.1.d. A copy of the
				governing body's written authorization empowering the CEO or his or
				her designee to authorize specified individuals to sign the
				application and to act on its behalf; and
4.1.e. A detailed description of
				the project, including but not limited to:
4.1.e.1. The location of the
				proposal;
4.1.e.2. A
				detailed statement of the services to be provided;
4.1.e.3. The exemption for which
				the applicant is applying with the appropriate Code citation;
4.1.e.4. A statement of
				the circumstances justifying approval of the exemption; and
4.1.e.5. A timetable for
				implementation of the project. In the case of a kidney disease
				treatment center, the facility must be operational within one year of
				the approval or the exemption will expire after one year.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-29 - Exemption From Certificate of Need › Section 65-29-5 - Expiration of Exemption

Current through Register Vol. XLI, No. 28, July 12, 2024
If a kidney disease treatment facility is not
				  operational within one year from the date of the decision on
				  exemption, the exemption will expire unless good cause can be
				  demonstrated.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-29 - Exemption From Certificate of Need › Section 65-29-6 - Appeals

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1. An
				appeal of the Authority's decision may be filed with the Office of
				Judges in accordance with W.Va. Code §
									16-2D-16.
6.2. In lieu of an appeal, the
				applicant may refile an application with the Authority.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-29 - Exemption From Certificate of Need › Section 65-29-7 - Notification of Completion of Project

Current through Register Vol. XLI, No. 28, July 12, 2024
The applicant shall notify the Authority in writing
				  upon the completion of the project. The notification shall contain a
				  brief description of the project, the assigned case file number, the
				  date of the completion of the project and the date that the project
				  became or will become operational.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. -- This
				legislative rule implements the provisions of the Certificate of Need program
				found at W. Va. Code §
									16-2D-1,
et seq.
as administered by the West Virginia Health Care Authority.
1.2. Authority. -- W. Va. Code §
									16-2D-4(a) and
				§16-29B-8(a)(1).
1.3. Filing
				Date. -- May 1, 2024.
1.4.
				Effective Date. -- May 1, 2024.
1.5. Sunset Date. -- This rule shall
				terminate and have no further force or effect August 1, 2029.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-3 - Certificate of Need Requirements

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1.
				A new health service as defined by W. Va. Code §
									16-2D-8 may not be acquired,
				offered, or developed within this state unless the Authority has issued a
				certificate of need for the new health service, subject to the exemptions in W.
				Va. Code §
									16-2D-9, §16-2D-10, and
				§16-2D-11.
3.2. A person or
				health care facility may not knowingly charge or bill for a health service as
				defined by W. Va. Code §
									16-2D-8 without first obtaining a
				certificate of need from the Authority.
3.3. Any charge or bill for a defined health
				service for which a certificate of need has not been issued by the Authority is
				void and legally unenforceable.
3.4. A transfer of equipment or facilities
				for less than fair market value is a new health service if a transfer of the
				equipment or facilities at fair market value would be subject to review by the
				Authority.
3.5. The Authority may
				determine a series of expenditures, each less than the expenditure minimum,
				which, when taken together, are in excess of the expenditure minimum, to be a
				single expenditure subject to the review of the Authority. In making that
				determination, the Authority shall consider the following:
3.5.a. Whether the expenditures are for
				components of a system which is required to accomplish a single
				purpose;
3.5.b. Whether the
				expenditures are to be made over a two-year period and are directed towards the
				accomplishment of a single goal; or
3.5.c. Whether the expenditures are to be
				made within a two-year period within a single department and constitute a
				significant modernization of the department.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-5 - Access to Information and Facilities

Current through Register Vol. XLI, No. 28, July 12, 2024
5.1. Upon proper notice, and when reasonable
				and necessary in the performance of the Authority's responsibilities in
				administering the certificate of need program, the Authority shall have access
				to any information, records, meetings, sites and/or facilities pertinent to an
				application under review by the Authority.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-6 - Additional Information or Amendments to Application

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1. After the review of an application has
				begun, the Authority may require the applicant to submit additional
				information. If no hearing is requested upon the application, and the applicant
				fails to submit the information within the time directed or if the applicant
				submits a substantial amendment to its application, the Authority may extend
				the review cycle for fifteen days at the request of the applicant.
6.2. If the additional information requested
				is not sufficient to satisfy the Authority's request or not timely received,
				the Authority may deny the application.
6.3. The Authority may examine the extent of
				additional information provided or any amendment made by the applicant
				regarding the application currently under consideration by the Authority and
				determine the application to be a new proposal subject to a new review cycle.
				The Authority shall notify the applicant of the determination, in writing, and
				further advise the applicant of the dates in the new review cycle. The
				Authority shall also publish notice of its action on its website.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-7 - Application Withdrawal

Current through Register Vol. XLI, No. 28, July 12, 2024
7.1. An
				applicant may withdraw an application under consideration by the Authority at
				any time prior to the issuance of a final written decision. The withdrawal of
				the application is without prejudice.
7.2. The applicant shall file with the
				Authority a written notice withdrawing the application before the issuance of a
				final written decision.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-8 - Application Review Procedure

Current through Register Vol. XLI, No. 28, July 12, 2024
8.1.
				Any person proposing a new health service shall file with the Authority a
				letter of intent 10 days before the submission of an application. The letter of
				intent shall contain sufficient information to advise the Authority of the
				nature, scope, cost, and timing of the project, as well as the location and
				name of the proposed applicant.
8.2. Notification of receipt of the letter of
				intent shall be published in a newspaper of general circulation in the area
				where the health service is being proposed. The newspaper notice shall contain
				a statement that further information regarding the application is on the
				Authority's website. The notification in the newspaper shall be provided within
				five days of receipt of the letter of intent. A copy of the letter of intent
				shall be placed on the Authority's website.
8.3. A certificate of need application must
				be filed 10 days after the letter of intent.
8.4. The application must be accompanied by
				the appropriate fees as defined in W. Va. Code §
									16-2D-13(b)(2).
				An application will not be accepted without the appropriate fee.
8.5. A copy of the application must be
				submitted to the Director of the Office of Insurance Consumer
				Advocacy.
8.6. Upon receipt of a
				certificate of need application, the Authority shall determine whether the
				application is complete or whether additional information is required. A
				declaration by the Authority that an application is complete means that there
				is sufficient information contained in the application for the Authority to
				make an informed decision. It does not mean that the approval of the
				application is warranted. Except in emergency situations that pose a threat to
				the public health, the Authority shall not declare an application complete if:
8.6.a. The applicant is a health care
				facility subject to the financial disclosure provisions of W. Va. Code §
										16-29B-24,
et
				seq
. or W. Va. Code §
										16-29B-1,
et
				seq
., and the health care facility has failed to file with the
				Authority all reports, records, data, or other information required by the code
				and the rules promulgated pursuant to the code.
8.6.b. Information provided in the
				application differs from information provided in the letter of intent;
				and
8.6.c. The application is not
				timely filed as provided in subsection 8.3. of this rule.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-9 - Extensions of Review Periods; Denials

Current through Register Vol. XLI, No. 28, July 12, 2024
9.1. At any time during the Authority's
				review of an application, the Authority may grant the applicant's request that
				the running of the review period be extended for 15 days.
9.2. If the Authority issues an extension of
				the review period, or for good cause, it may extend the file closing
				date.
9.3. Upon a finding by the
				Authority that it would not be practicable to complete the review of an
				application within the time provided by this rule, the Authority may deny the
				application.
9.4. Situations which
				would make it impracticable for the Authority to complete its review within the
				time provided by this rule include, but are not limited to the following:
9.4.a. The Authority has requested additional
				information from the applicant and the applicant has failed to provide all of
				the information to the Authority in the time frame directed by the
				Authority;
9.4.b. Weather
				conditions or other natural disasters have prevented the review process from
				taking place in a timely manner; and
9.4.c. Any of the circumstances listed in
				subsection 8.6. of this rule.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-10 - Decision

Current through Register Vol. XLI, No. 28, July 12, 2024
10.1. Except as
				provided later in this section, the Authority shall issue a certificate of need
				only if it makes the following written findings:
10.1.a. That the proposed new health service
				is needed;
10.1.b. With the
				exception of emergency circumstances that pose a threat to the public health,
				that the new health service is consistent with the State Health Plan. If the
				proposed new health service is not discussed in the State Health Plan, the
				Authority shall not disapprove the application solely for that
				reason;
10.1.c. That superior
				alternatives to the services in terms of cost, efficiency and appropriateness
				do not exist and that the development of alternatives is not
				practicable;
10.1.d. Existing
				facilities providing similar services to those proposed are using those
				services in an appropriate and efficient manner;
10.1.e. In the case of new construction,
				alternatives to new construction have been considered and have been implemented
				to the maximum extent possible, including modernization and sharing
				arrangements;
10.1.f. Patients will
				experience serious problems in obtaining care of the type proposed in the
				absence of the proposed new service; and
10.1.g. In the case of a proposal for the
				addition of beds for the provision of skilled nursing or intermediate care
				services, the addition will be consistent with the plans of other agencies of
				the state responsible for the provision and financing of long-term care
				facilities or services including home health services.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-11 - Appeal of Certificate of Need Decision

Current through Register Vol. XLI, No. 28, July 12, 2024
11.1. Decisions issued by the Authority prior
				to June 30, 2022, relating to the issuance, denial, or withdrawal of a
				certificate of need, shall be appealed by an affected person to the Office of
				Judges, West Virginia Office of the Insurance Commissioner. Affected persons
				shall address or deliver a request for review to West Virginia Health Care
				Authority/Office of Judges, P.O. Box 3585, Charleston, West Virginia
				25328.
11.2. For the purpose of
				administrative review of the Authority's decision, the Office of Judges shall
				conduct its proceedings in conformance with the West Virginia Rules of Civil
				Procedure and the Local Rules for the Circuit Court of Kanawha County, and its
				review of appeals in accordance with the provisions governing the judicial
				review of contested administrative cases in W. Va. Code §
									29A-5-4.
11.3. The Authority may stay the effect of
				the Authority's decision pending review. The stay shall be in writing and at
				the request of the person appealing the Authority's decision or the applicant
				seeking a certificate of need.
11.4. The person requesting a review of the
				Authority decision shall, as part of the request, include assignment(s) of
				error.
11.5. If a person requesting
				the review of the Authority's decision fails to appear at the date, time and
				place of the hearing, the Office of Judges shall, unless good cause is shown,
				dismiss the request for review.
11.6. The Office of Judges shall send its
				written findings to the person who requested the review, the person proposing
				the new health service, all other affected parties and the Authority. The
				Authority shall make copies of the decision available to others upon
				request.
11.7. If the Office of
				Judges remands the matter to the Authority, the remand order may establish a
				date by which the Authority shall complete further action. The order shall also
				state whether any findings of rulings of the Authority have been reversed or
				revised.
11.8. The Office of Judges
				may grant a continuance of a hearing upon a showing of good cause. If a request
				for a general continuance is made, and neither the person requesting the review
				or the applicant seeking the certificate of need for a new health service
				object, the Office of Judges may grant the request for a general continuance.
				The Office of Judges may dismiss the appeal with prejudice if the continuance
				continues for an unreasonable period of time and for good cause
				shown.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-12 - Judicial Review

Current through Register Vol. XLI, No. 28, July 12, 2024
12.1. Decisions
				issued by the Authority after June 30, 2022, relating to the issuance, denial,
				or withdrawal of a certificate of need, shall be appealed by an affected person
				to the West Virginia Intermediate Court of Appeals, pursuant to the provisions
				governing the judicial review of contested administrative cases found in W. Va.
				Code, §
									29A-5-1,
et seq
.
				Pursuant to W. Va. Code §
									51-11-7(b), all
				appeals shall be filed with the Clerk of the Supreme Court of
				Appeals.
12.2. The Authority may
				stay the effect of the Authority's decision pending review. The stay shall be
				in writing and at the request of the person appealing the Authority's decision
				or the applicant seeking a certificate of need.
12.3. The person requesting a review of the
				Authority decision shall, as part of the request, include assignment(s) of
				error.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-13 - Progress Reports/Extension of Certificate of Need

Current through Register Vol. XLI, No. 28, July 12, 2024
13.1. Any person holding a certificate of
				need shall submit to the Authority, in writing, a report on the progress being
				made toward completion of the approved project according to the timetable
				contained in the application. The progress report must contain a verification
				signed by the Chief Executive Officer and shall be submitted at least 45 days
				prior to the expiration of the certificate of need, or at any other time
				directed by the Authority. The report shall include, at a minimum, the
				following:
13.1.a. The current status of the
				project in relation to the timetable in the application;
13.1.b. The projected date of
				completion;
13.1.c. The cause or
				causes of any delays encountered;
13.1.d. Changes in the project, including any
				proposed changes for which a request is made for the Authority to determine
				whether the proposed change is reviewable as a substantial change or that an
				exemption previously granted should be withdrawn and the applicant be required
				to obtain a certificate of need for failure to meet the requirements of the
				exemption;
13.1.e. The projected
				total cost; and
13.1.f. Compliance
				with any conditions of certification.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-14 - Substantial Changes to Project After Issuance of Certificate of Need

Current through Register Vol. XLI, No. 28, July 12, 2024
14.1. In determining
				whether changes proposed to an approved project for which a certificate of need
				has been issued are substantial, the Authority shall consider the following as
				prima facie evidence of a substantial change.
14.1.a. A change in the location of the
				approved project which reduces the accessibility of patients who otherwise have
				no alternative to the services reasonably available or the change in location
				would adversely affect or impact an existing health care facility;
14.1.b. A change in the service area of the
				approved project;
14.1.c. A change
				in the location of the approved project to a county that was not significantly
				impacted by the proposal when it was originally approved;
14.1.d. An addition in the number of beds or
				a change in the types of beds;
14.1.e. The acquisition of major medical
				equipment not described in the application as part of the project or a capital
				expenditure for major medical equipment in excess of 10 percent over the
				approved capital expenditure for medical equipment;
14.1.f. The addition of health
				services;
14.1.g. An increase or
				decrease in square footage in excess of 10 percent of the originally approved
				footage or 1,000 square feet, whichever is greater; and
14.1.h. An unapproved capital expenditure, or
				an increase in the approved capital expenditure which is in excess of the
				expenditure minimum or in excess of 20 percent of the originally approved
				capital expenditure, whichever is less.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-15 - Transferability

Current through Register Vol. XLI, No. 28, July 12, 2024
15.1. A certificate
				of need is nontransferable. A transfer includes the sale, lease, transfer of
				stock or partnership shares, or other comparable arrangement which has the
				effect of transferring the control of the owner of the certificate of
				need.
15.2. If the Authority finds
				that a certificate of need has been transferred, the Authority shall withdraw
				the certificate.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-16 - Substantial Compliance Review

Current through Register Vol. XLI, No. 28, July 12, 2024
16.1.
				The Authority shall conduct a substantial compliance review of all new health
				services for which it has issued a certificate of need. No later than 45 days
				prior to licensure or the undertaking of the activity for which a certificate
				of need was issued, or an exemption granted, the applicant shall request, in
				writing, that the Authority undertake a substantial compliance review. The
				request shall contain a verification signed by the Chief Executive
				Officer.
16.2. The Authority shall
				issue its findings as to substantial compliance within 45 days of its receipt
				of a request for the review. If the Authority finds that the project is not in
				substantial compliance with its certificate of need, the Authority may withdraw
				the certificate and the Authority may direct that any license to operate the
				new service be revoked or denied, or the Authority may impose appropriate fines
				and/or seek an injunction against the use or operation of the new
				service.
16.3. If the Authority
				determines that it would be impracticable for the applicant to prepare and
				submit final cost figures for the project prior to the time the project is
				ready to be licensed or ready to undertake the activity for which a certificate
				of need was issued, the Authority may issue a conditional notice of substantial
				compliance, authorizing the licensure or the undertaking of the activity, for
				up to 12 months. The applicant shall prepare and submit documented final cost
				figures within the time designated by the Authority in its notice of
				substantial compliance. The Authority may withdraw a certificate of need if the
				applicant fails to submit the final cost figures within the time designated by
				the Authority. The Authority may impose appropriate fines and seek an
				injunction against the further use or operation of the new service.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-17 - Withdrawal of Certificate of Need

Current through Register Vol. XLI, No. 28, July 12, 2024
17.1.
				The Authority may withdraw a certificate of need for any of the following
				reasons:
17.1.a. Insufficient progress in
				meeting the timetable specified in the approved application for the certificate
				and for not making a good faith effort to meet it in developing the
				project;
17.1.b. Noncompliance with
				any conditions of certification;
17.1.c. A substantial change in an approved
				new health service for which the Authority has not issued a certificate of
				need;
17.1.d. A material
				misrepresentation by an applicant upon which the Authority relied in making its
				decision; or
17.1.e. Other reasons
				contained in the statute or this rule.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-18 - Declaratory Ruling or Ruling of Reviewability

Current through Register Vol. XLI, No. 28, July 12, 2024
18.1. A health care facility, health care
				provider or other entity regulated by the statute, or any person planning to
				acquire, offer or develop any new health service may apply to the Authority for
				a declaratory ruling on any matter regulated by the statute or any rule
				promulgated under the statute.
18.2. Any person acquiring, offering or
				developing a health service may apply to the Authority for a ruling regarding
				reviewability of the proposed health service. The request must be accompanied
				by a nonrefundable $100 fee.
18.3.
				Persons who request a declaratory ruling or a ruling regarding reviewability
				shall make the request in writing. They shall address the request to: Chairman,
				West Virginia Health Care Authority, 100 Dee Drive, Suite 201, Charleston, West
				Virginia 25311. The request shall contain a verification signed by the Chief
				Executive Officer.
18.4. Upon
				receipt of a request for declaratory ruling or a ruling regarding
				reviewability, the Authority shall issue its ruling within 45 days of its
				receipt of the request if all of the necessary information has been provided to
				the Authority in a timely manner. The Authority shall serve the ruling upon the
				person requesting the ruling and shall make the ruling available to any other
				person upon request and on payment of the cost set out in the fee schedule
				adopted by the Authority.
18.5. The
				Authority shall publish notice of its declaratory ruling or ruling regarding
				reviewability on its website.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-19 - Public Access to Information

Current through Register Vol. XLI, No. 28, July 12, 2024
19.1. The
				Authority shall make available for public inspection and examination all
				applications filed with the Authority and all other pertinent written materials
				filed with the Authority and essential to its review process. The Authority
				shall make copies of the applications or documents available to the public upon
				request. The Authority may charge its reasonable and customary fees for making
				the copies.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-20 - Addition of Health Services

Current through Register Vol. XLI, No. 28, July 12, 2024
20.1. The
				following health services are subject to certificate of need review pursuant to
				section W. Va. Code §
									16-2D-8(b),
				subject to the exemptions contained in W. Va. Code §
									16-2D-9, §16-2D-10, and
				§16-2D-11.
20.1.a. Providing radiation
				therapy;
20.1.b. Providing computed
				tomography;
20.1.c. Providing
				positron emission tomography;
20.1.d. Providing cardiac surgery;
20.1.e. Providing fixed magnetic resonance
				imaging;
20.1.f. Providing
				comprehensive medical rehabilitation;
20.1.g. Establishing an ambulatory care
				center;
20.1.h. Establishing an
				ambulatory surgical center;
20.1.i.
				Providing diagnostic imaging;
20.1.j. Providing cardiac catheterization
				services;
20.1.k. Constructing,
				developing, acquiring, or establishing of kidney disease treatment centers,
				including freestanding hemodialysis units;
20.1.l. Providing megavoltage radiation
				therapy;
20.1.m. Providing surgical
				services;
20.1.n. Establishing
				operating rooms;
20.1.o. Adding
				acute care beds;
20.1.p. Providing
				intellectual developmental disabilities services;
20.1.q. Providing organ and tissue
				transplants;
20.1.r. Establishing
				an intermediate care facility for individuals with intellectual
				disabilities;
20.1.s. Providing
				inpatient services;
20.1.t.
				Providing hospice services;
20.1.u.
				Establishing a home health agency; and
20.1.v. Providing personal care
				services.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-21 - Applicability

Current through Register Vol. XLI, No. 28, July 12, 2024
21.1. The Authority
				shall consider any application for which a review cycle has been established
				prior to the effective date of this rule under the rules in effect at the time
				the review cycle was established.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-34 - Uniform Bill Database › Section 65-34-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. -- This rule establishes
				procedures for the collection, retention, use, and disclosure of data from the
				uniform bill (UB) database, including provisions and safeguards to protect the
				privacy, integrity, confidentiality, and availability of any data; procedures
				for the collection of required data elements, required data format, code
				tables, edit specifications, thresholds required for a submission to be deemed
				complete, methods for submitting data, and submission schedules; and fees for
				data requests payable by users of the data, if any.
1.2. Authority. - W. Va. Code
				§
									16-29B-24.
1.3. Filing Date.
				- March 30, 2023.
1.4. Effective
				Date. - April 1, 2023.
1.5. Sunset
				Provision. - This rule shall terminate and have no further force or effect on
				August 1. 2028.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-34 - Uniform Bill Database › Section 65-34-2 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
2.1. De-identified data means all of the data
				elements listed in subsection 4.1. of this rule are omitted.
2.2. Health oversight agency means an agency
				or authority of the United States, a State, a territory, a political
				subdivision of a State or territory, or an Indian tribe, or a person or entity
				acting under a grant of authority from or contract with such public agency,
				including the employees or agents of such public agency or its contractors or
				persons or entities to whom it has granted authority, that is authorized by law
				to oversee the health care system (whether public or private) or government
				programs in which health information is necessary to determine eligibility or
				compliance, or to enforce civil rights laws for which health information is
				relevant.
2.3. Limited data set
				means one in which none of the data elements listed in subsection 5.9. of this
				rule are included.
2.4. Public
				health surveillance means the ongoing systematic collection, analysis, and
				interpretation of health-related data essential to planning, implementation,
				and evaluation of public health practices.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-34 - Uniform Bill Database › Section 64-34-3 - Data Collection and Retention

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. Pursuant to
				W. Va. Code §
									16-29B-30, and notwithstanding any other provision of the
				code to the contrary, as of July 1, 2017, and any and all functions of the West
				Virginia Health Care Authority (Authority) were transferred to the Department
				of Health and Human Resources (Department). This includes the responsibility
				for coordinating and overseeing health data collection and leading state
				agencies' efforts to make the best use of emerging technology to facilitate the
				expedient and appropriate exchange of health care data.
3.2. In some instances, the Department may
				hire a data discharge vendor to collect and analyze UB data directly from all
				non-federal acute care hospitals. The policies, procedures, schedules,
				specifications, and definitions of the West Virginia Hospital Data Submission
				System (HDSS) are found at "Appendix A" to this rule.
3.3. The data discharge vendor maintains the
				master database for the HDSS and provides copies of the data to the Department
				at least quarterly for storage in a data warehouse under the control of the
				Department. Since this data may, in some instances, contain identifiers that
				may, when linked with other sources or standing alone, lead to the identity of
				an individual, steps are taken to protect this data, to limit use of this data,
				and to restrict disclosure of this data.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-34 - Uniform Bill Database › Section 65-34-4 - Data Published on the Internet

Current through Register Vol. XLI, No. 28, July 12, 2024
4.1. Generally,
				data published on the internet will be de-identified in accordance with HIPAA
				privacy standards and will contain a cell size of at least 30. In order to
				de-identify data the following variables must be omitted:
4.1.1. Names;
4.1.2. All geographic subdivisions smaller
				than a state, including street address, city, precinct, zip code, and their
				equivalent geocodes, except for the initial three digits of a zip code if
				according to the current publicly available data from the Bureau of Census the
				initial geographic unit formed by combining all zip codes with the same three
				initial contains more than 20,000 and the initial three digits of a zip code
				for all such geographic units containing 20,000 or fewer is changed to
				000;
4.1.3. All elements of dates
				(except year) for dates directly related to an individual, including birth
				date, date of death, and all ages over 89 and all elements of dates (including
				year) indicative of such age, except that such ages and elements may be
				aggregated into a single category of 90 or older;
4.1.4. Telephone numbers;
4.1.5. Fax numbers;
4.1.6. Electronic mail addresses;
4.1.7. Social security numbers;
4.1.8. Medical record numbers;
4.1.9. Health plan beneficiary
				numbers;
4.1.10. Account
				numbers;
4.1.11.
				Certificate/license numbers;
4.1.12. Vehicle identifiers and serial
				numbers, including license plate numbers;
4.1.13. Device identifiers and serial
				numbers;
4.1.14. Web Universal
				Resource Locators (URLs);
4.1.15.
				Internet Protocol (IP) address numbers;
4.1.16. Biometric identifiers, including
				finger and voice prints;
4.1.17.
				Full face photographic images and any comparable images; and
4.1.18. Any other unique identifying number,
				characteristic, or code.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-34 - Uniform Bill Database › Section 65-34-6 - Fees

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1. The following fee structure has been
				established for certain types of reports and data in order to reasonably
				reimburse the Department for its costs in making copies of the reports
				available and in fulfilling custom requests:
6.1.1. Standard reports of financial and
				utilization statics: Paper copies are 50 cents per page; $10 per electronic
				file. Some reports may be retrieved electronically and free of charge from the
				Health Care Authority online archive at
http://www.hcawv.org/vs5FileNet/
.
6.1.2. Standard reports based upon hospital
				discharge uniform billing data: $50 per report. Some data may be retrieved
				electronically and free of charge using the Health IQ query tool at
https://hca.gov/data/Pages/default.aspx
;
				and from the AHRQ H-CUP query tool at
https://hcupnet.ahrq.gov/#setup
.
6.1.3. Custom reports based upon financial
				and utilization data or hospital uniform billing data sets: $50 per report.
				Additional fees may apply for excessive programming time.
6.1.4. Annual hospital discharge uniform
				billing data sets: Annual files are available for purchase from the AHRQ H-CUP
				central distributor at
http://www.hcup-us.ahrq.gov/tech_assist/centdist.jsp
.
6.1.5. Shipping: Additional shipping costs
				will be applied for costs above $1 or if signature confirmation of delivery is
				required by policy. No additional shipping cost will be incurred for certified
				mail delivery. Overnight delivery will be billed at the standard rate or
				charged to requestor's FedEx account.
6.1.6. Retrieval of paper reports from
				archival storage: $15 per box accessed to retrieve a document. This is the
				actual cost of document retrieval.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-34 - Uniform Bill Database › Section 65-34-7 - Requesting Data

Current through Register Vol. XLI, No. 28, July 12, 2024
7.1. Internal or
				external users may request a limited data set by submitting a data request
				form:
https://docs.google.com/forms/d/e/1FAIpQLSeBN9qaAyg5PYBYLGZIuEspIHu50gVp5vsDvPqeSPyBEKn0Eg/viewform
to the DHHR Office of Management Information Services, Data and Analytics.
7.1.1. Forms can be mailed, emailed to
				Michael.J.Morris@wv.gov or faxed to (304) 558-4775.
7.1.2. Requests may be approved as submitted
				or additional justification or modification may be required. Requests may also
				be denied.
7.1.3. External entities
				may be required to sign a Data Use Agreement at the discretion of the
				Department.
7.1.4. If a request is
				approved, an encrypted report will be sent to the requester within 30 days via
				Secure File Transfer Protocol.
West Virginia Code of State Rules › Agency 67 - Human Services › Title 67 - LEGISLATIVE RULE OFFICE OF DRUG CONTROL POLICY DEPARTMENT OF HUMAN SERVICES › Series 67-01 - Collection and Exchange of Data Related to Overdoses › Section 67-1-2 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
2.1. "Data and
				information" means a collection of numbers, characters, images, or other
				outputs from devices to convert physical quantities into symbols or images.
				Data includes, but is not limited to, numbers, words, and images. Data is
				typically further processed by a human or entered into a computer (input),
				stored and processed there, or transmitted (output) to another human, computer,
				or other system to create information.
2.2. "Data Request" means an inquiry from a
				participant for data or information collected by, housed, or maintained within
				the ODCP that requires compilation or aggregation by the ODCP staff.
2.3. "Department" means the West Virginia
				Department of Health and Human Resources and its successor
				departments.
2.4. "Director" means
				the Director of the Office of Drug Control Policy.
2.5. "Disclosure" means the release,
				transfer, provision, access to, or divulging in any other manner of information
				outside the ODCP.
2.6. "Drug"
				means:
2.6.1. Substances recognized as drugs
				in the official United States Pharmacopoeia, official Homeopathic Pharmacopoeia
				of the United States, or official National Formulary, or any supplement to any
				of them;
2.6.2. Substances intended
				for use in the diagnosis, cure, mitigation, treatment, or prevention of disease
				in man or animals;
2.6.3.
				Substances (other than food) intended to affect the structure or any function
				of the body of man or animals; and
2.6.4. Substances intended for use as
				components of any article specified in subdivisions a, b, or c, of this
				subsection. It does not include devices or their components, parts, or
				accessories.
West Virginia Code of State Rules › Agency 67 - Human Services › Title 67 - LEGISLATIVE RULE OFFICE OF DRUG CONTROL POLICY DEPARTMENT OF HUMAN SERVICES › Series 67-01 - Collection and Exchange of Data Related to Overdoses › Section 67-1-3 - Overdose reporting

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. A
				mandatory reporter who attends or treats, or who is requested to attend or
				treat, an overdose, or the administrator, or other person in charge of a health
				care provider in which an overdose is attended or treated or in which the
				attention or treatment is requested, shall report the case via an appropriate
				information technology platform with secure access.
3.2. Reports regarding an overdose shall
				include the reportable information within 24 hours after the incident
				response.
3.3. Reports must be
				submitted in accordance with state and federal security guidelines surrounding
				the transmission of confidential data.
3.4. The mandatory reporter making the report
				shall provide the reportable information concerning the person attended or
				treated or for whom treatment was sought.
3.5. All overdose reports submitted pursuant
				to this rule shall be handled in accordance with all applicable state and
				federal statutes and regulations pertaining to confidentiality of sensitive
				health care information.