Connecticut 2025 Regular Session

Connecticut House Bill HB07050 Compare Versions

Version 1 (Old)

Version 2 (New)

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3		-	LCO 5120 1 of 8
	3	+	LCO No. 5120 1 of 8
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5	5		General Assembly Raised Bill No. 7050
6	6		January Session, 2025
7	7		LCO No. 5120
8	8
9	9
10	10		Referred to Committee on PUBLIC HEALTH
11	11
12	12
13	13		Introduced by:
14	14		(PH)
	15	+
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18	19		AN ACT CONCERNING THE OFFICE OF HEALTH STRATEGY'S
19	20		RECOMMENDATIONS REGARDING THE CERTIFICATE OF NEED
20	21		PROGRAM.
21	22		Be it enacted by the Senate and House of Representatives in General
22	23		Assembly convened:
23	24
24	25		Section 1. Section 19a-643 of the general statutes is repealed and the 1
25	26		following is substituted in lieu thereof (Effective October 1, 2025): 2
26	27		(a) The Office of Health Strategy shall adopt regulations, in 3
27	28		accordance with the provisions of chapter 54, to carry out the provisions 4
28	29		of sections 19a-630 to 19a-639e, inclusive, as amended by this act, and 5
29	30		sections 19a-644 and 19a-645 concerning the submission of data by 6
30	31		health care facilities and institutions, including data on dealings 7
31	32		between health care facilities and institutions and their affiliates, and, 8
32	33		with regard to requests or proposals pursuant to sections 19a-638 to 19a-9
33	34		639e, inclusive, as amended by this act, by state health care facilities and 10
34	35		institutions, the ongoing inspections by the unit of operating budgets 11
35	36		that have been approved by the health care facilities and institutions, 12
36	37		standard reporting forms and standard accounting procedures to be 13
37		-	utilized by health care facilities and institutions and the transferability 14 Raised Bill No. 7050
	38	+	utilized by health care facilities and institutions and the transferability 14
	39	+	Raised Bill No. 7050
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39	41
40		-	LCO 5120 2 of 8
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	43	+	LCO No. 5120 2 of 8
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42	45		of line items in the approved operating budgets of the health care 15
43	46		facilities and institutions, except that any health care facility or 16
44	47		institution may transfer any amounts among items in its operating 17
45	48		budget. All such transfers shall be reported to the unit not later than 18
46	49		thirty days after the transfer or transfers. 19
47	50		(b) The [Office] Commissioner of Health Strategy may adopt such 20
48	51		regulations, in accordance with the provisions of chapter 54, as are 21
49	52		necessary to implement this chapter. The commissioner may implement 22
50	53		policies and procedures necessary to administer the provisions of this 23
51	54		section while in the process of adopting such policies and procedures as 24
52	55		regulations, provided the commissioner holds a public hearing on such 25
53	56		policies and procedures not less than thirty days before implementing 26
54	57		such policies and procedures and publishes notice of intention to adopt 27
55	58		regulations on the Office of Health Strategy's Internet web site and the 28
56	59		eRegulations System not later than twenty days after implementing 29
57	60		such policies and procedures. Policies and procedures implemented 30
58	61		pursuant to this subsection shall be valid until the time final regulations 31
59	62		are adopted in accordance with the provisions of chapter 54. 32
60	63		Sec. 2. Subdivision (15) of section 19a-630 of the general statutes is 33
61	64		repealed and the following is substituted in lieu thereof (Effective from 34
62	65		passage): 35
63	66		(15) "Termination of services" means the cessation of any services for 36
64	67		(A) a [period] combined total of greater than one hundred eighty days 37
65	68		within any consecutive two-year period, or (B) a period of thirty 38
66	69		consecutive days or more. 39
67	70		Sec. 3. Subdivision (11) of subsection (a) of section 19a-638 of the 40
68	71		general statutes is repealed and the following is substituted in lieu 41
69	72		thereof (Effective October 1, 2025): 42
70	73		(11) The acquisition of a proton radiotherapy machine or nonhospital 43
71	74		based linear [accelerators] accelerator, except a certificate of need issued 44
72	75		by the unit shall not be required where such machine or accelerator is a 45
73		-	~~replacement for [an] a machine or accelerator that was previously 46~~ Raised Bill No. 7050
	76	+	Raised Bill No. 7050
74	77
75	78
76		-	LCO 5120 3 of 8
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	80	+	LCO No. 5120 3 of 8
	81	+
	82	+	replacement for [an] a machine or accelerator that was previously 46
78	83		acquired through certificate of need approval or a certificate of need 47
79	84		determination; 48
80	85		Sec. 4. Subsection (d) of section 19a-639 of the general statutes is 49
81	86		repealed and the following is substituted in lieu thereof (Effective July 1, 50
82	87		2025): 51
83	88		(d) (1) For purposes of this subsection and subsection (e) of this 52
84	89		section: 53
85	90		(A) "Affected community" means a municipality where a hospital is 54
86	91		physically located or a municipality whose inhabitants are regularly 55
87	92		served by a hospital; 56
88	93		(B) "Hospital" has the same meaning as provided in section 19a-490; 57
89	94		(C) "New hospital" means a hospital as it exists after the approval of 58
90	95		an agreement pursuant to section 19a-486b or a certificate of need 59
91	96		application for a transfer of ownership of a hospital; 60
92	97		(D) "Purchaser" means a person who is acquiring, or has acquired, 61
93	98		any assets of a hospital through a transfer of ownership of a hospital; 62
94	99		(E) "Transacting party" means a purchaser and any person who is a 63
95	100		party to a proposed agreement for transfer of ownership of a hospital; 64
96	101		(F) "Transfer" means to sell, transfer, lease, exchange, option, convey, 65
97	102		give or otherwise dispose of or transfer control over, including, but not 66
98	103		limited to, transfer by way of merger or joint venture not in the ordinary 67
99	104		course of business; and 68
100	105		(G) "Transfer of ownership of a hospital" means a transfer that 69
101	106		impacts or changes the governance or controlling body of a hospital, 70
102	107		including, but not limited to, all affiliations, mergers or any sale or 71
103	108		transfer of net assets of a hospital and for which a certificate of need 72
104	109		application or a certificate of need determination letter is filed on or after 73
105		-	~~December 1, 2015. 74~~ Raised Bill No. 7050
	110	+	Raised Bill No. 7050
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	114	+	LCO No. 5120 4 of 8
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	116	+	December 1, 2015. 74
110	117		(2) In any deliberations involving a certificate of need application 75
111	118		filed pursuant to section 19a-638, as amended by this act, that involves 76
112	119		the transfer of ownership of a hospital, the unit shall, in addition to the 77
113	120		guidelines and principles set forth in subsection (a) of this section and 78
114	121		those prescribed through regulation pursuant to subsection (c) of this 79
115	122		section, take into consideration and make written findings concerning 80
116	123		each of the following guidelines and principles: 81
117	124		(A) Whether the applicant fairly considered alternative proposals or 82
118	125		offers in light of the purpose of maintaining health care provider 83
119	126		diversity and consumer choice in the health care market and access to 84
120	127		affordable quality health care for the affected community; and 85
121	128		(B) Whether the plan submitted pursuant to section 19a-639a, as 86
122	129		amended by this act, demonstrates, in a manner consistent with this 87
123	130		chapter, how health care services will be provided by the new hospital 88
124	131		for the first three years following the transfer of ownership of the 89
125	132		hospital, including any consolidation, reduction, elimination or 90
126	133		expansion of existing services or introduction of new services. 91
127	134		(3) The unit shall deny any certificate of need application involving a 92
128	135		transfer of ownership of a hospital unless the commissioner finds that 93
129	136		the affected community will be assured of continued access to high 94
130	137		quality and affordable health care after accounting for any proposed 95
131	138		change impacting hospital staffing. 96
132	139		(4) The unit may deny any certificate of need application involving a 97
133	140		transfer of ownership of a hospital subject to a cost and market impact 98
134	141		review pursuant to section 19a-639f, as amended by this act, if the 99
135	142		commissioner finds that (A) the affected community will not be assured 100
136	143		of continued access to high quality and affordable health care after 101
137	144		accounting for any consolidation in the hospital and health care market 102
138	145		that may lessen health care provider diversity, consumer choice and 103
139	146		access to care, and (B) any likely increases in the prices for health care 104
140		-	services or total health care spending in the state may negatively impact 105
141		-	the affordability of care. 106 Raised Bill No. 7050
	147	+	Raised Bill No. 7050
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144		-	LCO 5120 5 of 8
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	151	+	LCO No. 5120 5 of 8
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	153	+	services or total health care spending in the state may negatively impact 105
	154	+	the affordability of care. 106
146	155		(5) The unit may place any conditions on the approval of a certificate 107
147	156		of need application involving a transfer of ownership of a hospital 108
148	157		consistent with the provisions of this chapter. Before placing any such 109
149	158		conditions, the unit shall weigh the value of such conditions in 110
150	159		promoting the purposes of this chapter against the individual and 111
151	160		cumulative burden of such conditions on the transacting parties and the 112
152	161		new hospital. For each condition imposed, the unit shall include a 113
153	162		concise statement of the legal and factual basis for such condition and 114
154	163		the provision or provisions of this chapter that it is intended to promote. 115
155	164		Each condition shall be reasonably tailored in time and scope. The 116
156	165		transacting parties or the new hospital shall have the right to make a 117
157	166		request to the unit for an amendment to, or relief from, any condition 118
158	167		based on changed circumstances, hardship or for other good cause. 119
159	168		(6) In any deliberations involving a certificate of need application 120
160	169		filed pursuant to section 19a-638, as amended by this act, that involves 121
161	170		the transfer of ownership of a hospital and is subject to a cost and market 122
162	171		impact review, the unit may consider the preliminary report, response 123
163	172		to the preliminary report, final report and any written comments from 124
164	173		the parties regarding the reports issued or submitted as part of the 125
165	174		review. 126
166	175		Sec. 5. Section 19a-639a of the general statutes is amended by adding 127
167	176		subsection (i) as follows (Effective July 1, 2025): 128
168	177		(NEW) (i) (1) Notwithstanding the provisions of this section, the unit 129
169	178		may develop and implement an expedited certificate of need review 130
170	179		process for (A) certificate of need applications for (i) a service, facility or 131
171	180		equipment identified as having a significant unmet need in the 132
172	181		geographic region of the applicant in the most recently published final 133
173	182		version of the state-wide health care facilities and services plan, 134
174	183		established pursuant to section 19a-634, (ii) the acquisition of a 135
	184	+	Raised Bill No. 7050
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	186	+
	187	+
	188	+	LCO No. 5120 6 of 8
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175	190		computed tomography scanner or magnetic resonance imaging scanner, 136
176	191		and (B) any other category of certificate of need application under 137
177	192		subsection (a) of section 19a-638, as amended by this act, that the unit 138
178		-	designates as eligible to request expedited review, provided the 139 Raised Bill No. 7050
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	193	+	designates as eligible to request expedited review, provided the 139
183	194		applicant, pursuant to subdivision (2) of this subsection, (i) requests an 140
184	195		expedited review of a certificate of need application, and (ii) clearly 141
185	196		demonstrates that the subject of the application addresses a significant 142
186	197		unmet need in the service area of the applicant. The unit shall issue a 143
187	198		decision on any certificate of need application eligible for expedited 144
188	199		review pursuant to the provisions of this subdivision not more than 145
189	200		thirty days after the unit receives an applicant's complete certificate of 146
190	201		need application. 147
191	202		(2) An expedited certificate of need applicant may request, in a form 148
192	203		and manner prescribed by the Commissioner of Health Strategy, an 149
193	204		expedited review of a certificate of need application pursuant to 150
194	205		subparagraph (B) of subdivision (1) of this subsection. Such request 151
195	206		shall include, but need not be limited to, (A) a description of the target 152
196	207		population to be served by the subject of the certificate of need 153
197	208		application, (B) a clear demonstration of a significant unmet need for the 154
198	209		subject of the certificate of need application in the geographic region of 155
199	210		the applicant based on patient demographics, diagnoses, utilization or 156
200	211		other recent data, and (C) a description of the availability of the subject 157
201	212		of the certificate of need application in the primary service area of the 158
202	213		applicant. The unit shall determine whether an applicant who requests 159
203	214		an expedited review pursuant to the provisions of this subdivision is 160
204	215		eligible for such expedited review not more than thirty days after the 161
205	216		date that the unit receives the applicant's request. 162
206	217		(3) Notwithstanding the provisions of this section, the expedited 163
207	218		certificate of need review process established pursuant to the provisions 164
208	219		of this subsection shall (A) allow the unit to resolve an expedited 165
209	220		certificate of need application by (i) agreed settlement with the 166
210	221		applicant, (ii) making a determination approving the expedited 167
211	222		certificate of need application with or without conditions, or (iii) 168
	223	+	Raised Bill No. 7050
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	227	+	LCO No. 5120 7 of 8
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212	229		requiring the applicant to submit a certificate of need application 169
213	230		pursuant to the provisions of subsections (a) to (f), inclusive, of this 170
214	231		section, and (B) not require a public hearing on an expedited certificate 171
215		-	of need application. 172 Raised Bill No. 7050
216		-
217		-
218		-	LCO 5120 7 of 8
219		-
	232	+	of need application. 172
220	233		(4) If the unit requires an applicant to submit a certificate of need 173
221	234		application pursuant to subparagraph (A)(iii) of subdivision (3) of this 174
222	235		subsection, the unit shall (A) treat the expedited review application as a 175
223	236		properly filed certificate of need application, (B) issue any request for 176
224	237		additional information not later than thirty days after issuing a notice 177
225	238		requiring an applicant to submit a certificate of need application 178
226	239		pursuant to said subparagraph, and (C) follow the procedures described 179
227	240		in subsections (c) to (g), inclusive, of this section. 180
228	241		(5) The expedited certificate of need review process established 181
229	242		pursuant to the provisions of this subsection shall not be considered a 182
230	243		contested case, as defined in section 4-166. The unit's decision on any 183
231	244		expedited certificate of need application submitted pursuant to the 184
232	245		provisions of this subsection shall not be considered a final decision, as 185
233	246		defined in section 4-166. 186
234	247		Sec. 6. Subsection (j) of section 19a-639f of the general statutes is 187
235	248		repealed and the following is substituted in lieu thereof (Effective October 188
236	249		1, 2025): 189
237	250		(j) The unit shall retain an independent consultant with expertise on 190
238	251		the economic analysis of the health care market and health care costs 191
239	252		and prices to conduct each cost and market impact review, as described 192
240	253		in this section. The unit shall submit bills for such services to the 193
241	254		purchaser, as defined in subsection (d) of section 19a-639, as amended 194
242	255		by this act. Such purchaser shall pay such bills not later than thirty days 195
243	256		after receipt. Such bills shall not exceed [two] three hundred thousand 196
244	257		dollars per application. The provisions of chapter 57, sections 4-212 to 4-197
245	258		219, inclusive, and section 4e-19 shall not apply to any agreement 198
246	259		executed pursuant to this subsection. 199
	260	+	Raised Bill No. 7050
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	262	+
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	264	+	LCO No. 5120 8 of 8
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247	266		This act shall take effect as follows and shall amend the following
248	267		sections:
249	268
250	269		Section 1 October 1, 2025 19a-643
251	270		Sec. 2 from passage 19a-630(15)
252		-	Sec. 3 October 1, 2025 19a-638(a)(11) Raised Bill No. 7050
253		-
254		-
255		-	LCO 5120 8 of 8
256		-
	271	+	Sec. 3 October 1, 2025 19a-638(a)(11)
257	272		Sec. 4 July 1, 2025 19a-639(d)
258	273		Sec. 5 July 1, 2025 19a-639a(i)
259	274		Sec. 6 October 1, 2025 19a-639f(j)
260	275
261		-	PH Joint Favorable
	276	+	Statement of Purpose:
	277	+	To make various revisions to the certificate of need program.
	278	+
	279	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	280	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	281	+	underlined.]
262	282