West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-22 - Temporary Approval Of Discount Contracts For Border Hospitals › Section 65-22-6 - Effective Date of Temporary Approval; Retroactive Review

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1. Upon obtaining temporary approval of any
				proposed discount contract, the contract is further subject to retroactive
				review by the Authority in accordance with the criteria set forth in W. Va.
				Code '16-29B-20 and the rate
				review procedures set forth in W. Va. Code '16-29B-21.
6.2. The effective date of any temporary
				approval is the date which is five (5) days from the date of filing of a
				verified notice meeting the requirements of section five of this rule or the
				date the Authority determines the verified notice is complete, whichever first
				occurs.
6.3. Upon receipt of a
				verified notice meeting the requirements of section five of this rule, the
				Authority shall maintain the information contained in and related to the
				proposed discount contract in a confidential manner to be used only by the
				Authority, its staff and its agents and independent contractors for regulatory
				purposes. The confidentiality shall be maintained only until the commencement
				of the retroactive review of the discount contract in accordance with
				subsection 6.5 of this rule. The review for all pertinent purposes shall
				commence upon the filing by the border hospital of its next succeeding rate
				application except upon the issuance by the Authority of a protective order in
				accordance with section seven of this rule.
6.4. Following receipt of a verified notice
				complying with the requirements of section five of this rule, the Authority
				shall for the purpose of retroactive review under this rule determine within
				fifteen (15) days thereafter whether or not the verified notice is complete. If
				the verified notice is not determined complete, the Authority may request
				additional information from the border hospital. Upon receipt of the additional
				information from the border hospital, the Authority again has fifteen (15) days
				within which to determine whether or not the verified notice is
				complete.
6.5. Upon determining
				that the verified notice is complete in accordance with the requirements of
				section five of this rule, the Authority shall publish a notice of the
				determination of completeness and/or temporary approval of the discount
				contract, as may be appropriate, in the Saturday Charleston newspapers and the
				State Register and shall retroactively review the proposed discount contract
				with the hospital's next succeeding rate application in order to determine
				whether the discount contract meets all of the requirements for final approval
				set forth in W. Va. Code '16-29B-20.
6.6. In the event that the Authority
				determines that the discount contract does not meet all of the requirements for
				temporary approval set forth in section four of this rule subsequent to a
				temporary approval of the contract, the Authority may issue an order denying
				and revoking the temporary approval of the discount contract at any time after
				such temporary approval. The order is effective as of a date established by the
				Authority in the order. The effective date shall not be less than ten (10) days
				from the date of the order and which effective date may exceed ten (10) days
				from the date of said order in the discretion of the Authority upon good cause
				shown for the extension.
6.7. In
				the event that the Authority determines during retroactive review in accordance
				with this section that the discount contract meets the standards for final
				approval of discount contracts set forth in W. Va. Code '16-29B-20, the
				Authority shall issue a final order approving the discount contract in
				accordance with the procedures for rate review set forth in W. Va. Code
				'16-29B-21. The final
				order is effective as of the date of publication of the notice of determination
				of completeness.
6.8. In the event
				that the Authority determines that the discount contract does not meet the
				standards for final approval of discount contracts set forth in W. Va. Code
				'16-29B-20, the
				Authority shall issue a final order denying approval of the discount contract
				and rescinding the previous temporary approval in accordance with the
				procedures for rate review set forth in W. Va. Code '16-29B-21. The final
				order is effective as of the date established by the Authority in the order.
				The effective date of a final order denying approval of a discount contract
				which was previously temporarily approved shall not be less than ten (10) days
				from the date of the order, but may be extended by the Authority for a period
				not in excess of thirty (30) days from the date of the order upon good cause
				shown by the border hospital for the extension.