Connecticut 2016 Regular Session

Connecticut House Bill HB05211 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	General Assembly Raised Bill No. 5211
2	2	February Session, 2016 LCO No. 1088
3	3	01088_______PH_
4	4	Referred to Committee on PUBLIC HEALTH
5	5	Introduced by:
6	6	(PH)
7	7
8	8	General Assembly
9	9
10	10	Raised Bill No. 5211
11	11
12	12	February Session, 2016
13	13
14	14	LCO No. 1088
15	15
16	16	01088_______PH_
17	17
18	18	Referred to Committee on PUBLIC HEALTH
19	19
20	20	Introduced by:
21	21
22	22	(PH)
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24	24	AN ACT CONCERNING CERTIFICATES OF NEED.
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26	26	Be it enacted by the Senate and House of Representatives in General Assembly convened:
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28	28	Section 1. Section 19a-630 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):
29	29
30	30	As used in this chapter, unless the context otherwise requires:
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32	32	(1) "Affiliate" means a person, entity or organization controlling, controlled by or under common control with another person, entity or organization. Affiliate does not include a medical foundation organized under chapter 594b.
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34	34	(2) "Applicant" means any person or health care facility that applies for a certificate of need pursuant to section 19a-639a, as amended by this act.
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36	36	(3) "Bed capacity" means the total number of inpatient beds in a facility licensed by the Department of Public Health under sections 19a-490 to 19a-503, inclusive.
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38	38	(4) "Capital expenditure" means an expenditure that under generally accepted accounting principles consistently applied is not properly chargeable as an expense of operation or maintenance and includes acquisition by purchase, transfer, lease or comparable arrangement, or through donation, if the expenditure would have been considered a capital expenditure had the acquisition been by purchase.
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40	40	(5) "Certificate of need" means a certificate issued by the office.
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42	42	(6) "Days" means calendar days.
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44	44	(7) "Deputy commissioner" means the deputy commissioner of Public Health who oversees the Office of Health Care Access division of the Department of Public Health.
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46	46	(8) "Commissioner" means the Commissioner of Public Health.
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48	48	(9) "Free clinic" means a private, nonprofit community-based organization that provides medical, dental, pharmaceutical or mental health services at reduced cost or no cost to low-income, uninsured and underinsured individuals.
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50	50	(10) "Large group practice" means eight or more full-time equivalent physicians, legally organized in a partnership, professional corporation, limited liability company formed to render professional services, medical foundation, not-for-profit corporation, faculty practice plan or other similar entity (A) in which each physician who is a member of the group provides substantially the full range of services that the physician routinely provides, including, but not limited to, medical care, consultation, diagnosis or treatment, through the joint use of shared office space, facilities, equipment or personnel; (B) for which substantially all of the services of the physicians who are members of the group are provided through the group and are billed in the name of the group practice and amounts so received are treated as receipts of the group; or (C) in which the overhead expenses of, and the income from, the group are distributed in accordance with methods previously determined by members of the group. An entity that otherwise meets the definition of group practice under this section shall be considered a group practice although its shareholders, partners or owners of the group practice include single-physician professional corporations, limited liability companies formed to render professional services or other entities in which beneficial owners are individual physicians.
51	51
52	52	(11) "Health care facility" means (A) hospitals licensed by the Department of Public Health under chapter 368v; (B) specialty hospitals; (C) freestanding emergency departments; (D) outpatient surgical facilities, as defined in section 19a-493b and licensed under chapter 368v; (E) a hospital or other facility or institution operated by the state that provides services that are eligible for reimbursement under Title XVIII or XIX of the federal Social Security Act, 42 USC 301, as amended; (F) a central service facility; (G) mental health facilities; (H) substance abuse treatment facilities; and (I) any other facility requiring certificate of need review pursuant to subsection (a) of section 19a-638. "Health care facility" includes any parent company, subsidiary, affiliate or joint venture, or any combination thereof, of any such facility.
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54	54	(12) "Nonhospital based" means located at a site other than the main campus of the hospital.
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56	56	(13) "Office" means the Office of Health Care Access division within the Department of Public Health.
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58	58	(14) "Person" means any individual, partnership, corporation, limited liability company, association, governmental subdivision, agency or public or private organization of any character, but does not include the agency conducting the proceeding.
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60	60	(15) "Physician" has the same meaning as provided in section 20-13a.
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62	62	(16) "Transfer of ownership" means a transfer that impacts or changes the governance or controlling body of a health care facility, institution or large group practice, including, but not limited to, all affiliations, mergers or any sale or transfer of net assets of a health care facility.
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64	64	(17) "Reduction of specialty services" means a fifty per cent or greater decrease of direct care staff hours within a health care facility unit that provides inpatient or outpatient obstetric and maternity, pediatric, emergency or critical care services.
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66	66	Sec. 2. Subsection (a) of section 19a-638 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):
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68	68	(a) A certificate of need issued by the office shall be required for:
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70	70	(1) The establishment of a new health care facility;
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72	72	(2) A transfer of ownership of a health care facility;
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74	74	(3) A transfer of ownership of a large group practice to any entity other than a (A) physician, or (B) group of two or more physicians, legally organized in a partnership, professional corporation or limited liability company formed to render professional services and not employed by or an affiliate of any hospital, medical foundation, insurance company or other similar entity;
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76	76	(4) The establishment of a freestanding emergency department;
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78	78	(5) The termination of inpatient or outpatient services offered by a hospital, including, but not limited to, the termination by a short-term acute care general hospital or children's hospital of inpatient and outpatient mental health and substance abuse services;
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80	80	(6) The establishment of an outpatient surgical facility, as defined in section 19a-493b, or as established by a short-term acute care general hospital;
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82	82	(7) The termination of surgical services by an outpatient surgical facility, as defined in section 19a-493b, or a facility that provides outpatient surgical services as part of the outpatient surgery department of a short-term acute care general hospital, provided termination of outpatient surgical services due to (A) insufficient patient volume, or (B) the termination of any subspecialty surgical service, shall not require certificate of need approval;
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84	84	(8) The termination of an emergency department by a short-term acute care general hospital;
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86	86	(9) The establishment of cardiac services, including inpatient and outpatient cardiac catheterization, interventional cardiology and cardiovascular surgery;
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88	88	(10) The acquisition of computed tomography scanners, magnetic resonance imaging scanners, positron emission tomography scanners or positron emission tomography-computed tomography scanners, by any person, physician, provider, short-term acute care general hospital or children's hospital, except (A) as provided for in subdivision (22) of subsection (b) of this section, and (B) a certificate of need issued by the office shall not be required where such scanner is a replacement for a scanner that was previously acquired through certificate of need approval or a certificate of need determination;
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90	90	(11) The acquisition of nonhospital based linear accelerators;
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92	92	(12) An increase in the licensed bed capacity of a health care facility;
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94	94	(13) The acquisition of equipment utilizing technology that has not previously been utilized in the state;
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96	96	(14) An increase of two or more operating rooms within any three-year period, commencing on and after October 1, 2010, by an outpatient surgical facility, as defined in section 19a-493b, or by a short-term acute care general hospital; [and]
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98	98	(15) The termination of inpatient or outpatient services offered by a hospital or other facility or institution operated by the state that provides services that are eligible for reimbursement under Title XVIII or XIX of the federal Social Security Act, 42 USC 301, as amended; and
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100	100	(16) The reduction of specialty services offered by a hospital.
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102	102	Sec. 3. Subsection (a) of section 19a-639 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):
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104	104	(a) In any deliberations involving a certificate of need application filed pursuant to section 19a-638, as amended by this act, the office shall take into consideration and make written findings concerning each of the following guidelines and principles:
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106	106	(1) Whether the proposed project is consistent with any applicable policies and standards adopted in regulations by the Department of Public Health;
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108	108	(2) The relationship of the proposed project to the state-wide health care facilities and services plan;
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110	110	(3) Whether there is a clear public need for the health care facility or services proposed by the applicant;
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112	112	(4) Whether the applicant has satisfactorily demonstrated how the proposal will impact the financial strength of the health care system in the state or that the proposal is financially feasible for the applicant;
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114	114	(5) Whether the applicant has satisfactorily demonstrated how the proposal will improve quality, accessibility and cost effectiveness of health care delivery in the region, including, but not limited to, provision of or any change in the access to services for Medicaid recipients and indigent persons;
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116	116	(6) The applicant's past and proposed provision of health care services to relevant patient populations and payer mix, including, but not limited to, access to services by Medicaid recipients and indigent persons;
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118	118	(7) Whether the applicant has satisfactorily identified the population to be served by the proposed project and satisfactorily demonstrated that the identified population has a need for the proposed services;
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120	120	(8) The utilization of existing health care facilities and health care services in the service area of the applicant;
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122	122	(9) Whether the applicant has satisfactorily demonstrated that the proposed project shall not result in an unnecessary duplication of existing or approved health care services or facilities;
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124	124	(10) Whether an applicant, who has failed to provide or reduced access to services by Medicaid recipients or indigent persons, has demonstrated good cause for doing so, which shall not be demonstrated solely on the basis of differences in reimbursement rates between Medicaid and other health care payers;
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126	126	(11) Whether the applicant has satisfactorily demonstrated that the proposal will not negatively impact the diversity of health care providers and patient choice in the geographic region; [and]
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128	128	(12) Whether the applicant has satisfactorily demonstrated that any consolidation resulting from the proposal will not adversely affect health care costs or accessibility to care; and
129	129
130	130	(13) Whether the applicant has satisfactorily demonstrated that the proposal will meet the health care needs of the public in the geographic region served by considering any community needs assessment.
131	131
132	132	Sec. 4. Subsection (e) of section 19a-639a of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):
133	133
134	134	(e) Except as provided in this subsection, the office shall hold a public hearing in the affected community, as defined in subsection (d) of section 19a-639, on a properly filed and completed certificate of need application if [three or more individuals or an individual representing an entity with five or more people] any individual submits a request, in writing, that a public hearing be held on the application. For a properly filed and completed certificate of need application involving a transfer of ownership of a large group practice, as described in subdivision (3) of subsection (a) of section 19a-638, as amended by this act, when an offer was made in response to a request for proposal or similar voluntary offer for sale, a public hearing shall be held if twenty-five or more individuals or an individual representing twenty-five or more people submits a request, in writing, that a public hearing be held on the application. Any request for a public hearing shall be made to the office not later than thirty days after the date the office determines the application to be complete.
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136	136	Sec. 5. Section 19a-641 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2016):
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138	138	Any health care facility or institution, [and] any state health care facility or institution, any three or more individuals, collectively, or any individual representing an entity with five or more people, aggrieved by any final decision of said office under the provisions of sections 19a-630 to 19a-639e, inclusive, as amended by this act, may appeal from such decision in accordance with the provisions of section 4-183, except venue shall be in the judicial district in which it is located. Such appeal shall have precedence in respect to order of trial over all other cases except writs of habeas corpus, actions brought by or on behalf of the state, including informations on the relation of private individuals, and appeals from awards or decisions of workers' compensation commissioners.
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143	143	This act shall take effect as follows and shall amend the following sections:
144	144	Section 1 October 1, 2016 19a-630
145	145	Sec. 2 October 1, 2016 19a-638(a)
146	146	Sec. 3 October 1, 2016 19a-639(a)
147	147	Sec. 4 October 1, 2016 19a-639a(e)
148	148	Sec. 5 October 1, 2016 19a-641
149	149
150	150	This act shall take effect as follows and shall amend the following sections:
151	151
152	152	Section 1
153	153
154	154	October 1, 2016
155	155
156	156	19a-630
157	157
158	158	Sec. 2
159	159
160	160	October 1, 2016
161	161
162	162	19a-638(a)
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164	164	Sec. 3
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166	166	October 1, 2016
167	167
168	168	19a-639(a)
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170	170	Sec. 4
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172	172	October 1, 2016
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174	174	19a-639a(e)
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176	176	Sec. 5
177	177
178	178	October 1, 2016
179	179
180	180	19a-641
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182	182	Statement of Purpose:
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184	184	To change the requirements for certificates of need.
185	185
186	186	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]