2015 -- H 5683

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LC001811

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2015

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A N   A C T

RELATING TO HEALTH AND SAFETY - DETERMINATION OF NEED FOR NEW

HEALTHCARE EQUIPMENT AND SERVICES

     

     Introduced By: Representative Teresa A. Tanzi

     Date Introduced: February 26, 2015

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 23-15-2 of the General Laws in Chapter 23-15 entitled

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"Determination of Need for New Health Care Equipment and New Institutional Health Services"

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is hereby amended to read as follows:

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     23-15-2. Definitions. -- As used in this chapter:

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      (1) "Affected person" means and includes the person whose proposal is being reviewed,

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or the applicant, health care facilities located within the state which provide institutional health

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services, the state medical society, the state osteopathic society, those voluntary nonprofit area-

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wide planning agencies that may be established in the state, the state budget office, the office of

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health insurance commissioner, any hospital or medical service corporation organized under the

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laws of the state, the statewide health coordinating council, contiguous health systems agencies,

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and those members of the public who are to be served by the proposed new institutional health

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services or new health care equipment.

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      (2) "Cost impact analysis" means a written analysis of the effect that a proposal to offer

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or develop new institutional health services or new health care equipment, if approved, will have

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on health care costs and shall include any detail that may be prescribed by the state agency in

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rules and regulations.

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      (3) "Director" means the director of the Rhode Island state department of health.

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      (4) (i) "Health care facility" means any institutional health service provider, facility or

 

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institution, place, building, agency, or portion of them, whether a partnership or corporation,

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whether public or private, whether organized for profit or not, used, operated, or engaged in

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providing health care services, which are limited to hospitals, nursing facilities, home nursing

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care provider, home care provider, hospice provider, inpatient rehabilitation centers (including

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drug and/or alcohol abuse treatment centers), certain facilities providing surgical treatment to

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patients not requiring hospitalization (surgi-centers, multi-practice physician ambulatory surgery

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centers and multi-practice podiatry ambulatory surgery centers) and facilities providing inpatient

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hospice care. Single-practice physician or podiatry ambulatory surgery centers (as defined in

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subdivisions 23-17-2(13) and 23-17-2(14), respectively) are exempt from the requirements of

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chapter 15 of this title; provided, however, that such exemption shall not apply if a single-

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practice physician or podiatry ambulatory surgery center is established by a medical practice

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group (as defined in ยง 5-37-1) within two (2) years following the formation of such medical

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practice group, when such medical practice group is formed by the merger or consolidation of

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two (2) or more medical practice groups or the acquisition of one medical practice group by

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another medical practice group. The term "health care facility" does not include Christian Science

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institutions (also known as Christian Science nursing facilities) listed and certified by the

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Commission for Accreditation of Christian Science Nursing Organizations/Facilities, Inc.

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      (ii) Any provider of hospice care who provides hospice care without charge shall be

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exempt from the provisions of this chapter.

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      (5) "Health care provider" means a person who is a direct provider of health care

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services (including but not limited to physicians, dentists, nurses, podiatrists, physician assistants,

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or nurse practitioners) in that the person's primary current activity is the provision of health care

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services for persons.

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      (6) "Health services" means organized program components for preventive, assessment,

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maintenance, diagnostic, treatment, and rehabilitative services provided in a health care facility.

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      (7) "Health services council" means the advisory body to the Rhode Island state

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department of health established in accordance with chapter 17 of this title, appointed and

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empowered as provided to serve as the advisory body to the state agency in its review functions

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under this chapter.

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      (8) "Institutional health services" means health services provided in or through health

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care facilities and includes the entities in or through which the services are provided.

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      (9) "New health care equipment" means any single piece of medical equipment (and any

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components which constitute operational components of the piece of medical equipment)

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proposed to be utilized in conjunction with the provision of services to patients or the public, the

 

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capital costs of which would exceed two million two hundred fifty thousand dollars ($2,250,000);

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provided, however, that the state agency shall exempt from review any application which

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proposes one for one equipment replacement as defined in regulation. Further, beginning July 1,

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2012 and each July thereafter the amount shall be adjusted by the percentage of increase in the

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consumer price index for all urban consumers (CPI-U) as published by the United States

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department of labor statistics as of September 30 of the prior calendar year.

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      (10) "New institutional health services" means and includes:

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      (i) Construction, development, or other establishment of a new health care facility.

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      (ii) Any expenditure except acquisitions of an existing health care facility which will not

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result in a change in the services or bed capacity of the health care facility by or on behalf of an

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existing health care facility in excess of five million two hundred fifty thousand dollars

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($5,250,000) which is a capital expenditure including expenditures for predevelopment activities;

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provided further, beginning July 1, 2012 and each July thereafter the amount shall be adjusted by

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the percentage of increase in the consumer price index for all urban consumers (CPI-U) as

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published by the United States department of labor statistics as of September 30 of the prior

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calendar year.

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      (iii) Where a person makes an acquisition by or on behalf of a health care facility or

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health maintenance organization under lease or comparable arrangement or through donation,

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which would have required review if the acquisition had been by purchase, the acquisition shall

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be deemed a capital expenditure subject to review.

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      (iv) Any capital expenditure which results in the addition of a health service or which

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changes the bed capacity of a health care facility with respect to which the expenditure is made,

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except that the state agency may exempt from review by rules and regulations promulgated for

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this chapter any bed reclassifications made to licensed nursing facilities and annual increases in

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licensed bed capacities of nursing facilities that do not exceed the greater of ten (10) beds or ten

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percent (10%) of facility licensed bed capacity and for which the related capital expenditure does

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not exceed two million dollars ($2,000,000).

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      (v) Any health service proposed to be offered to patients or the public by a health care

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facility which was not offered on a regular basis in or through the facility within the twelve (12)

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month period prior to the time the service would be offered, and which increases operating

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expenses by more than one million five hundred thousand dollars ($1,500,000), except that the

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state agency may exempt from review by rules and regulations promulgated for this chapter any

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health service involving reclassification of bed capacity made to licensed nursing facilities.

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Further beginning July 1, 2012 and each July thereafter the amount shall be adjusted by the

 

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percentage of increase in the consumer price index for all urban consumers (CPI-U) as published

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by the United States department of labor statistics as of September 30 of the prior calendar year.

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      (vi) Any new or expanded tertiary or specialty care service, regardless of capital expense

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or operating expense, as defined by and listed in regulation, the list not to exceed a total of twelve

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(12) categories of services at any one time and shall include full body magnetic resonance

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imaging and computerized axial tomography; provided, however, that the state agency shall

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exempt from review any application which proposes one for one equipment replacement as

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defined by and listed in regulation. Acquisition of full body magnetic resonance imaging and

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computerized axial tomography shall not require a certificate of need review and approval by the

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state agency if satisfactory evidence is provided to the state agency that it was acquired for under

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one million dollars ($1,000,000) on or before January 1, 2010 and was in operation on or before

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July 1, 2010.

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      (11) "Person" means any individual, trust or estate, partnership, corporation (including

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associations, joint stock companies, and insurance companies), state or political subdivision, or

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instrumentality of a state.

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      (12) "Predevelopment activities" means expenditures for architectural designs, plans,

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working drawings and specifications, site acquisition, professional consultations, preliminary

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plans, studies, and surveys made in preparation for the offering of a new institutional health

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service.

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      (13) "State agency" means the Rhode Island state department of health.

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      (14) "To develop" means to undertake those activities which, on their completion, will

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result in the offering of a new institutional health service or new health care equipment or the

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incurring of a financial obligation, in relation to the offering of that service.

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      (15) "To offer" means to hold oneself out as capable of providing, or as having the

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means for the provision of, specified health services or health care equipment.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY - DETERMINATION OF NEED FOR NEW

HEALTHCARE EQUIPMENT AND SERVICES

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     This act would exempt home care providers from the requirement of a certificate of need

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review prior to an expansion of services contained in the determination of need under the Health

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Care Equipment and Services Act.

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     This act would take effect upon passage.

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