Chapter 212
2011 -- S 0203
Enacted 07/01/11
A N A C T
RELATING TO
HEALTH AND SAFETY - DETERMINATION OF NEED FOR NEW HEALTH CARE EQUIPMENT AND NEW
INSTITUTIONAL HEALTH SERVICES
Introduced
By: Senators Perry, DeVall, Tassoni,
Date Introduced: February 09, 2011
It is enacted by the
General Assembly as follows:
SECTION 1. Section 23-15-2 of the General Laws in Chapter 23-15
entitled
"Determination of Need
for New Health Care Equipment and New Institutional Health Services"
is hereby amended to read as follows:
23-15-2.
Definitions. -- As used in this chapter:
(1) "Affected
person" means and includes the person whose proposal is being reviewed,
or the applicant, health care facilities located within
the state which provide institutional health
services, the state medical society, the state osteopathic
society, those voluntary nonprofit area-
wide planning agencies that may be established in the
state, the state budget office, the office of
health insurance commissioner, any hospital or medical
service corporation organized under the
laws of the state, the statewide health coordinating
council, contiguous health systems agencies,
and those members of the public who are to be served by
the proposed new institutional health
services or new health care equipment.
(2) "Cost impact
analysis" means a written analysis of the effect that a proposal to offer
or develop new institutional health services or new
health care equipment, if approved, will have
on health care costs and shall include any detail that
may be prescribed by the state agency in
rules and regulations.
(3)
"Director" means the director of the
(4) (i) "Health care
facility" means any institutional health service provider, facility or
institution, place, building, agency, or portion of them, whether
a partnership or corporation,
whether public or private, whether organized for profit or
not, used, operated, or engaged in
providing health care services, which are limited to hospitals,
nursing facilities, home nursing
care provider, home care provider, hospice provider, inpatient rehabilitation centers (including
drug and/or alcohol abuse treatment centers), certain
facilities providing surgical treatment to
patients not requiring hospitalization (surgi-centers,
multi-practice physician ambulatory surgery
centers and multi-practice podiatry ambulatory surgery
centers) and facilities providing inpatient
hospice care. Single-practice physician or podiatry
ambulatory surgery centers (as defined in
subdivisions 23-17-2(13) and 23-17-2(14), respectively) are exempt
from the requirements of
chapter 15 of this title; provided, however, that such
exemption shall not apply if a single-
practice physician or podiatry ambulatory surgery center is
established by a medical practice
group (as defined in section 5-37-1) within two (2) years
following the formation of such
medical practice group, when such medical practice group is
formed by the merger or
consolidation of two (2) or more medical practice groups or the
acquisition of one medical
practice group by another medical practice group. The term
"health care facility" does not include
Christian Science institutions (also known as
Christian Science nursing facilities) listed and
certified by the Commission for Accreditation of Christian
Science Nursing
Organizations/Facilities, Inc.
(ii) Any provider of
hospice care who provides hospice care without charge shall be
exempt from the provisions of this chapter.
(5) "Health care
provider" means a person who is a direct provider of health care
services (including but not limited to physicians, dentists,
nurses, podiatrists, physician assistants,
or nurse practitioners) in that the person's primary
current activity is the provision of health care
services for persons.
(6) "Health
services" means organized program components for preventive, assessment,
maintenance, diagnostic, treatment, and rehabilitative services
provided in a health care facility.
(7) "Health
services council" means the advisory body to the
department of health established in accordance with chapter 17
of this title, appointed and
empowered as provided to serve as the advisory body to the
state agency in its review functions
under this chapter.
(8) "Institutional
health services" means health services provided in or through health
care facilities and includes the entities in or through
which the services are provided.
(9) "New health
care equipment" means any single piece of medical equipment (and any
components which constitute operational components of the piece
of medical equipment)
proposed to be utilized in conjunction with the provision of
services to patients or the public, the
capital costs of which would exceed one million dollars
($1,000,000); provided, however, that the
state agency shall exempt from review any application which
proposes one for one equipment
replacement as defined in regulation.
(10) "New
institutional health services" means and includes:
(i)
Construction, development, or other establishment of a new health care
facility.
(ii) Any expenditure
except acquisitions of an existing health care facility which will not
result in a change in the services or bed capacity of the
health care facility by or on behalf of an
existing health care facility in excess of two million dollars
($2,000,000) which is a capital
expenditure including expenditures for predevelopment activities.
(iii) Where a person
makes an acquisition by or on behalf of a health care facility or
health maintenance organization under lease or comparable
arrangement or through donation,
which would have required review if the acquisition had
been by purchase, the acquisition shall
be deemed a capital expenditure subject to review.
(iv)
Any capital expenditure which results in the addition of a health
service or which
changes the bed capacity of a health care facility with
respect to which the expenditure is made,
except that the state agency may exempt from review by rules
and regulations promulgated for
this chapter any bed reclassifications made to licensed
nursing facilities and annual increases in
licensed bed capacities of nursing facilities that do not
exceed the greater of ten (10) beds or ten
percent (10%) of facility licensed bed capacity and for which
the related capital expenditure does
not exceed two million dollars ($2,000,000).
(v) Any health service
proposed to be offered to patients or the public by a health care
facility which was not offered on a regular basis in or
through the facility within the twelve (12)
month period prior to the time the service would be
offered, and which increases operating
expenses by more than seven hundred and fifty thousand dollars
($750,000), except that the state
agency may exempt from review by rules and regulations
promulgated for this chapter any health
service involving reclassification of bed capacity made to
licensed nursing facilities.
(vi)
Any new or expanded tertiary or specialty care service, regardless of
capital expense
or operating expense, as defined by and listed in
regulation, the list not to exceed a total of twelve
(12) categories of services
at any one time and shall include full body magnetic resonance
imaging and computerized axial tomography; provided, however,
that the state agency shall
exempt from review any application which proposes one for
one equipment replacement as
defined by and listed in regulation. Acquisition of full body
magnetic resonance imaging and
computerized axial tomography shall not require a certificate of
need review and approval by the
state agency if satisfactory evidence is provided to the
state agency that it was acquired for under
one million dollars ($1,000,000) on or before January 1,
2010 and was in operation on or before
July 1, 2010.
(11) "Person"
means any individual, trust or estate, partnership, corporation (including
associations, joint stock companies, and insurance companies),
state or political subdivision, or
instrumentality of a state.
(12)
"Predevelopment activities" means expenditures for architectural
designs, plans,
working drawings and specifications, site acquisition,
professional consultations, preliminary
plans, studies, and surveys made in preparation for the
offering of a new institutional health
service.
(13) "State
agency" means the
(14) "To
develop" means to undertake those activities which, on their completion,
will
result in the offering of a new institutional health service
or new health care equipment or the
incurring of a financial obligation, in relation to the
offering of that service.
(15) "To
offer" means to hold oneself out as capable of providing, or as having the
means for the provision of, specified health services or
health care equipment.
SECTION 2. This act shall take effect upon passage.
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LC01023
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