West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-26 - Benchmarking And Discount Contract Rule › Section 65-26-13 - Interim Order

Current through Register Vol. XLI, No. 28, July 12, 2024
13.1. If a
				hearing is requested on the hospital's rate application by an affected party,
				which is not the applicant or the Authority, and the request for hearing is not
				later withdrawn by the affected party, the hospital may, within fifteen (15)
				days of receipt of the hearing request, request the Authority to establish an
				interim rate pending the final order of the Authority.
13.2. The interim rate shall be calculated by
				the Authority from the information contained in the pending application. The
				Authority shall review any overage which the hospital may have at the time of
				the filing of the rate application and consider the amount of the overage in
				determining the interim rate.
13.3.
				The Authority shall approve or deny an interim rate for the hospital within
				thirty (30) days after the receipt of the request for an interim rate by the
				hospital. The interim rate shall remain in effect for six (6) months from the
				effective date of the interim order or until the effective date of a final
				order, whichever first occurs. If a final order is not entered within six (6)
				months from the effective date of the interim rate, the interim rate expires at
				the conclusion of the six (6) month period and the hospital shall implement the
				rates which were last approved by the Authority by a final order.
13.4. The Authority may rescind the interim
				rate during the six (6) month period if it finds that the hospital made
				material misrepresentations to the Authority; that the application and/or
				interim rate request is based upon inaccurate data; or that other good cause
				exists for rescission.
13.5. If the
				Authority approves an interim rate increase for the hospital, the Authority may
				order the hospital to keep a detailed and accurate account of all amounts
				received by reason of the increase in rates and the purchasers and third-party
				payors from whom the amounts were received. The Authority may order the
				hospital to refund with interest to each affected purchaser and/or third-party
				payor any part of the increase in rates that may be held to be excessive or
				unreasonable. In the event a refund is not practicable, the hospital shall,
				under appropriate terms and conditions determined by the board, temporarily
				decrease its rates by an amount equal to the income realized from that portion
				of the increase in rates which was subsequently held to be excessive or
				unreasonable.
13.6. If the final
				order subsequently entered by the Authority establishes revenue limits for the
				hospital which are greater than the interim revenue limits, the hospital shall
				not increase its rates in excess of the limits approved by the final
				order.
13.7. The interim rate
				request is discretionary with the hospital and the interim order issued by the
				Authority is not a final or appealable order pursuant to W.Va. Code §
									16-29B-13.