| Chapter 308 |
| 2025 -- H 5351 SUBSTITUTE A AS AMENDED Enacted 06/30/2025 |
| A N A C T |
| RELATING TO HEALTH AND SAFETY -- MEDICAL SPAS SAFETY ACT |
Introduced By: Representatives Baginski, Bennett, and Casey |
| Date Introduced: February 07, 2025 |
| It is enacted by the General Assembly as follows: |
| SECTION 1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby |
| amended by adding thereto the following chapter: |
| CHAPTER 104 |
| MEDICAL SPAS SAFETY ACT |
| 23-104-123-105-1. Definitions. |
| For purposes of this chapter: |
| (1) "Ablative lasers" or "ablative energy devices" means lasers intended to excise or |
| vaporize the outer layer of skin. |
| (2) "Advanced practice registered nurse" or "APRN" means a registered nurse who has an |
| active, unrestricted advanced practice registered nurse license granted under the authority of |
| chapter 34 of title 5. |
| (3) "Certified nurse practitioner" means a certified nurse practitioner as defined in § 5-34- |
| 3. |
| (4) "Cosmetic medical procedure" means any procedure that does not require sedation that |
| is performed on a person and is directed at improving the person's appearance and does not |
| meaningfully promote the proper function of the body or prevent or treat illness or disease. |
| Cosmetic medical procedures may include, but are not limited to, microneedling, hair transplants, |
| cosmetic injections, cosmetic soft tissue fillers, dermaplaning, dermastamping, dermarolling, |
| microdermabrasion, chemical peels, laser resurfacing, laser treatment of veins, sclerotherapy, other |
| laser procedures, intense pulsed light, ablative laser, permanent fat removal, radio frequency |
| microneedling, platelet-rich plasma, platelet-rich fibrin, and the use of class II medical devices |
| designed to induce deep skin tissue alteration. A cosmetic medical service shall be performed by a |
| delegate only if the services are within the scope of the delegate and have been delegated by a |
| medical director, supervising physician, supervising PA, or supervising CNP who is responsible |
| for supervision of the services performed. |
| (5) "Delegate" means a licensed non-physician tasked with performing a cosmetic medical |
| procedure as defined in this section by a physician, PA, or CNP. |
| (6) "Department" means the Rhode Island department of health. |
| (7) "Medical director" means a physician or certified nurse practitioner who assumes the |
| role of, or holds oneself out as, medical director. The medical director shall be: |
| (i) Trained in the indications for, and performance of, cosmetic medical procedures, |
| including all medical devices or instruments that can alter or cause biological change or damage |
| the skin and subcutaneous tissue. Training programs provided by a manufacturer or vendor of a |
| medical device or supplies shall not be a medical director's, supervising physician's, PA's, or CNP's |
| only education in the cosmetic medical service or the operation of medical devices to be used; |
| (ii) Responsible for implementing policies and procedures to ensure quality patient care; |
| (iii) Responsible for the delegation and supervision of cosmetic procedures; |
| (iv) Responsible for the oversight of all cosmetic medical procedures performed by |
| physicians, PAs, CNPs, and non-physicians; and |
| (v) Responsible for ensuring that all supervising physicians, supervising PAs, and |
| supervising CNPs, any physicians, PAs, and APRNs performing cosmetic medical procedures, and |
| any non-physicians, non-PAs, and non-APRNs delegated to perform cosmetic medical procedures, |
| are properly trained in the safe and effective performance of all cosmetic medical procedures that |
| they perform at the medical spa. |
| (8) "Medical spa" means a licensed establishment in which cosmetic medical procedures |
| are performed. |
| (9) "Physician" means an allopath or osteopath who has an active, unrestricted medical |
| license granted under the provisions of chapter 37 of title 5. |
| (10) "Physician assistant" or "PA" means a person who is licensed and qualified by |
| academic and practical training to provide medical and surgical services in collaboration with |
| physicians. |
| (11) "Supervision" means an arrangement when a qualified supervising physician, a |
| physician assistant in collaboration with a physician, or a CNP is either: |
| (i) On site and able to directly observe the treatment being performed, though not |
| necessarily in the same room (i.e., direct supervision); or |
| (ii) Is off site, but is in the state and immediately available if needed, either in person or by |
| telecommunication (i.e., indirect supervision). |
| 23-104-223-105-2. Protection of patients in a medical spa. |
| (a) Each medical spa shall appoint a medical director who shall be: |
| (1) Trained in the indications for, and performance of, cosmetic medical procedures, |
| including all medical devices or instruments that can alter or cause biological change or damage to |
| the skin or subcutaneous tissue. Training programs provided by a manufacturer or vendor of a |
| medical device or supplies shall not be a medical director's, supervising physician's, supervising |
| PA in collaboration with a physician, or CNP's only education in the cosmetic medical service or |
| the operation of medical devices to be used; |
| (2) Responsible for implementing policies and procedures to ensure quality patient care; |
| (3) Responsible for the delegation and supervision of cosmetic procedures; |
| (4) Responsible for developing and maintaining written office protocols for each cosmetic |
| medical procedure. Such protocols shall be kept on site at the medical spa for review and/or |
| inspection by the department.; |
| (5) Responsible for the oversight of all cosmetic medical procedures performed by |
| physicians, PAs, APRNs, and RNs; |
| (6) Responsible for ensuring that all supervisory physicians, supervising PAs in |
| collaboration with a physician and supervising APRNs, any physicians, PAs and APRNs |
| performing cosmetic medical procedures, and any non-physicians and non-APRNs delegated to |
| perform cosmetic medical procedures, are properly trained in the safe and effective performance of |
| all cosmetic medical procedures that they perform at the medical spa; and |
| (7) On site or off site and able to directly observe the treatment being performed, though |
| not necessarily in the same room (i.e., direct supervision). |
| (b) A physician, PA, or APRN who performs cosmetic medical procedures, or supervises |
| such procedures delegated to and performed by a non-physician, non-PA, or non-APRN, must be |
| trained in the indications for and performance of the cosmetic medical procedure. An APRN who |
| performs cosmetic medical procedures, or supervises such procedures delegated to and performed |
| by a non-physician, non-PA, or non-APRN, must be accredited by the state board of nursing. |
| (c) The supervising physician, supervising APRN, or supervising PA in collaboration with |
| a physician shall: |
| (1) Perform an initial assessment of the patient. |
| (2) Prepare a written treatment plan for each patient, which plan shall include, as |
| applicable, diagnoses, course of treatment, and specifications for any device being used. |
| (3) Obtain patient consent and document the patient's consent, in the patient’s medical |
| record. |
| (4) Create and maintain medical records in a manner consistent with applicable laws and |
| regulations and accepted medical practice. |
| (d) Non-physicians, non-PAs, and non-APRNs may only perform cosmetic medical |
| procedures: |
| (1) For which they have the requisite training; and |
| (2) Which have been delegated to them by a supervising physician, supervising PA in |
| collaboration with a physician or supervising APRN. |
| (e) At all times in the performance of their duties relative to cosmetic procedures, all |
| providers shall: |
| (1) Review and follow written protocols for each delegated cosmetic medical procedure; |
| (2) Verify that the supervising physician, supervising PA in collaboration with a physician |
| or supervising APRN has assessed the patient and given written treatment instructions for each |
| procedure performed; |
| (3) Review the cosmetic medical procedure with each patient; |
| (4) Notify the medical director, as well as the supervising physician, supervising PA in |
| collaboration with a physician or supervising APRN, before the patient leaves or as they become |
| aware, of any adverse events or complications, and follow up with the patient post-procedure, as |
| appropriate; |
| (5) Document all relevant details of the performed cosmetic medical procedure in the |
| patient’s medical record; and |
| (6) As applicable, satisfy any requirements imposed upon them by their licensing boards. |
| (f) Medical procedures using ablative lasers or ablative energy devices shall only be |
| performed by physicians, physician assistants, and certified nurse practitioners. |
| 23-104-323-105-3. Rules and regulations. |
| The department shall, by July 1, 2026, promulgate rules and regulations necessary and not |
| inconsistent with law to implement the purpose and intent of this chapter, which rules and |
| regulations shall provide for, though not be limited to, the licensing of medical spas as health |
| carehealthcare facilities. |
| SECTION 2. Section 23-17-2 of the General Laws in Chapter 23-17 entitled "Licensing of |
| Healthcare Facilities" is hereby amended to read as follows: |
| 23-17-2. Definitions. |
| As used in this chapter: |
| (1) “Affiliate” means a legal entity that is in control of, is controlled by, or is in common |
| control with another legal entity. |
| (2) “Alzheimer’s dementia special-care unit or program” means a distinct living |
| environment within a nursing facility that has been physically adapted to accommodate the |
| particular needs and behaviors of those with dementia. The unit provides increased staffing; |
| therapeutic activities designed specifically for those with dementia; and trains its staff on an |
| ongoing basis on the effective management of the physical and behavioral problems of those with |
| dementia. The residents of the unit/program have had a standard, medical-diagnostic evaluation |
| and have been determined to have a diagnosis of Alzheimer’s dementia or another dementia. |
| (3) “Certified nurse-teacher” means those personnel certified by the department of |
| elementary and secondary education and employed pursuant to the provisions of §§ 16-21-7 and |
| 16-21-8. |
| (4)(i) “Change in operator” means a transfer by the governing body or operator of a |
| healthcare facility to any other person (excluding delegations of authority to the medical or |
| administrative staff of the facility) of the governing body’s authority to: |
| (A) Hire or fire the chief executive officer of the healthcare facility; |
| (B) Maintain and control the books and records of the healthcare facility; |
| (C) Dispose of assets and incur liabilities on behalf of the healthcare facility; or |
| (D) Adopt and enforce policies regarding operation of the healthcare facility. |
| (ii) This definition is not applicable to circumstances wherein the governing body of a |
| healthcare facility retains the immediate authority and jurisdiction over the activities enumerated |
| in subsections (4)(i)(A) — (4)(i)(D). |
| (5) “Change in owner” means: |
| (i) In the case of a healthcare facility that is a partnership, the removal, addition, or |
| substitution of a partner that results in a new partner acquiring a controlling interest in the |
| partnership; |
| (ii) In the case of a healthcare facility that is an unincorporated, solo proprietorship, the |
| transfer of the title and property to another person; |
| (iii) In the case of a healthcare facility that is a corporation: |
| (A) A sale, lease exchange, or other disposition of all, or substantially all, of the property |
| and assets of the corporation; or |
| (B) A merger of the corporation into another corporation; or |
| (C) The consolidation or two (2) or more corporations, resulting in the creation of a new |
| corporation; or |
| (D) In the case of a healthcare facility that is a business corporation, any transfer of |
| corporate stock that results in a new person acquiring a controlling interest in the corporation; or |
| (E) In the case of a healthcare facility that is a nonbusiness corporation, any change in |
| membership that results in a new person acquiring a controlling vote in the corporation. |
| (6) “Clinician” means a physician licensed under chapter 37 of title 5; a nurse licensed |
| under chapter 34 of title 5; a psychologist licensed under chapter 44 of title 5; a social worker |
| licensed under chapter 39.1 of title 5; a physical therapist licensed under chapter 40 of title 5; and |
| a speech language pathologist or audiologist licensed under chapter 48 of title 5 or physician |
| assistant licensed under the provisions of chapter 54 of title 5. |
| (7) “Director” means the director of the Rhode Island state department of health. |
| (8) “Freestanding emergency-care facility” means an establishment, place, or facility that |
| may be a public or private organization, structurally distinct and separate from a hospital; staffed, |
| equipped, and operated to provide prompt, emergency medical care. For the purposes of this |
| chapter, “emergency medical care” means services provided for a medical condition or behavioral- |
| health condition that is manifested by symptoms of sufficient severity that, in the absence of |
| immediate medical attention, could result in harm to the person or others; serious impairment to |
| bodily functions; serious dysfunction of any bodily organ or part; or development or continuance |
| of severe pain. |
| (9) “Healthcare facility” means any institutional health-service provider, facility, or |
| institution, place, building, agency, or portion thereof, whether a partnership or corporation, |
| whether public or private, whether organized for profit or not, used, operated, or engaged in |
| providing healthcare services, including, but not limited to: hospitals; nursing facilities; home |
| nursing-care provider (which shall include skilled nursing services and may also include activities |
| allowed as a home-care provider or as a nursing service agency); home-care provider (which may |
| include services such as personal care or homemaker services); rehabilitation centers; kidney |
| disease treatment centers; health maintenance organizations; freestanding emergency-care facilities |
| as defined in this section, and facilities providing surgical treatment to patients not requiring |
| hospitalization (surgi-centers); hospice care,; and physician ambulatory-surgery centers and |
| podiatry ambulatory-surgery centers providing surgical treatment. The term “healthcare facility” |
| also includes organized ambulatory-care facilities that are not part of a hospital but that are |
| organized and operated to provide healthcare services to outpatients, such as: central-services |
| facilities serving more than one healthcare facility or healthcare provider; treatment centers; |
| diagnostic centers; outpatient clinics; medical spas as defined in chapter 104105 of this title23; |
| infirmaries and health centers; school-based health centers, and neighborhood health centers. The |
| term “healthcare facility” also includes a mobile health-screening vehicle as defined in this section. |
| The term “healthcare facility” shall not apply to organized, ambulatory-care facilities owned and |
| operated by professional service corporations as defined in chapter 5.1 of title 7, as amended (the |
| “professional service corporation law”), or to a practitioner’s (physician, dentist, or other healthcare |
| provider) office or group of practitioners’ offices (whether owned and/or operated by a hospital or |
| an affiliate of a hospital or an individual practitioner, alone or as a member of a partnership, |
| professional service corporation, organization, or association); provided, however, notwithstanding |
| any other provision herein or in the general laws, any hospital or any affiliate of a hospital that |
| owns and/or operates a practitioner’s office shall ensure that such practitioner’s office complies |
| with licensing or accreditation requirements that may be applicable to the practitioner’s office. |
| Individual categories of healthcare facilities shall be defined in rules and regulations promulgated |
| by the licensing agency with the advice of the health services council. Rules and regulations |
| concerning hospice care shall be promulgated with regard to the “Standards of a Hospice Program |
| of Care,” promulgated by the National Hospice Organization. Any provider of hospice care who |
| provides hospice care without charge shall be exempt from the licensing provisions of this chapter |
| but shall meet the “Standards of a Hospice Program of Care.” Facilities licensed by the department |
| of behavioral healthcare, developmental disabilities and hospitals and the department of human |
| services, and clinical laboratories licensed in accordance with chapter 16.2 of this title, as well as |
| 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. shall not be considered healthcare facilities for purposes of this |
| chapter. |
| (10) “Homemaker,” or however else called, means a trained, nonprofessional worker who |
| performs related housekeeping services in the home for the sick, disabled, dependent, or infirm, |
| and as further defined by regulation; the director shall establish criteria for training. |
| (11) “Hospital” means a person or governmental entity licensed in accordance with this |
| chapter to establish, maintain, and operate a hospital. |
| (12) “Licensing agency” means the Rhode Island state department of health. |
| (13) “Medical services” means any professional services and supplies rendered by, or under |
| the direction of, persons duly licensed under the laws of this state to practice medicine, surgery, or |
| podiatry that may be specified by any medical service plan. Medical service shall not be construed |
| to include hospital services. |
| (14) “Mobile health-screening vehicle” means a mobile vehicle, van, or trailer that delivers |
| primary and preventive healthcare screening services, and: |
| (i) Does not maintain active contracts or arrangements with any health insurer subject to |
| regulation under chapter 20 or 42 of title 27; |
| (ii) Does not maintain active contracts or arrangements with another licensed healthcare |
| facility as that term is defined within this section; and |
| (iii) Does not provide medical services free of charge. |
| (15) “Non-English speaker” means a person who cannot speak or understand, or has |
| difficulty in speaking or understanding, the English language, because he/she uses only, or |
| primarily, a spoken language other than English, and/or a person who uses a sign language and |
| requires the use of a sign-language interpreter to facilitate communication. |
| (16) “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. |
| (17) “Physician ambulatory-surgery center” means an office, or portion of an office, that |
| is utilized for the purpose of furnishing surgical services to the owner and/or operator’s own |
| patients on an ambulatory basis, and shall include both single-practice, physician ambulatory- |
| surgery centers and multi-practice, physician ambulatory-surgery centers. A “single-practice, |
| physician ambulatory-surgery center” is a physician ambulatory center owned and/or operated by |
| a physician-controlled professional service corporation as defined in chapter 5.1 of title 7 (the |
| “professional service corporation law”), or a physician-controlled limited-liability company (as |
| defined in chapter 16 of title 7 (the “limited liability company act”)) in which no physician is an |
| officer, shareholder, director, or employee of any other corporation engaged in the practice of the |
| same profession, or a private physician’s office (whether owned and/or operated by an individual |
| practitioner, alone or as a member of a partnership, professional service corporation, limited- |
| liability company, organization, or association). A “multi-practice, physician ambulatory-surgery |
| center” is a physician ambulatory-surgery center owned and/or operated by a physician-controlled |
| professional service corporation (as defined in the professional service corporation law) or a |
| physician-controlled limited-liability company (as defined in the limited liability company act) in |
| which a physician is also an officer, shareholder, director, or employee of another corporation |
| engaged in the practice of the same profession, or a group of physicians’ offices (whether owned |
| and/or operated by an individual practitioner, alone or as a member of a partnership, professional |
| service corporation, limited-liability company, organization, or association). |
| (18) “Podiatry ambulatory-surgery center” means an office or portion of an office that is |
| utilized for the purpose of furnishing surgical services to the owner and/or operator’s own patients |
| on an ambulatory basis, and shall include both single-practice, podiatry ambulatory-surgery centers |
| and multi-practice podiatry ambulatory-surgery centers. A “single-practice podiatry ambulatory- |
| surgery center” is a podiatry ambulatory center owned and/or operated by a podiatrist-controlled |
| professional service corporation (as defined in chapter 5.1 of title 7 (the “professional service |
| corporation law”)), or a podiatrist-controlled limited-liability company (as defined in chapter 16 of |
| title 7 (the “limited liability company act”)) in which no podiatrist is an officer, shareholder, |
| director, or employee of any other corporation engaged in the practice of the same profession, or a |
| private podiatrist’s office (whether owned and/or operated by an individual practitioner, alone or |
| as a member of a partnership, professional service corporation, limited-liability company, |
| organization, or association). A “multi-practice, podiatry ambulatory-surgery center” is a podiatry |
| ambulatory-surgery center owned and/or operated by a podiatrist-controlled professional service |
| corporation (as defined in the professional service corporation law) or a podiatrist-controlled, |
| limited-liability company (as defined in the limited liability company act) in which a podiatrist is |
| also an officer, shareholder, director, or employee of another corporation engaged in the practice |
| of the same profession, or a group of podiatrists’ offices (whether owned and/or operated by an |
| individual practitioner, alone or as a member of a partnership, professional service corporation, |
| limited-liability company, organization, or association). |
| (19) “Qualified interpreter” means a person who, through experience and/or training, is |
| able to translate a particular foreign language into English, with the exception of sign-language |
| interpreters who must be licensed in accordance with chapter 71 of title 5. |
| (20) “Qualified sign-language interpreter” means one who has been licensed in accordance |
| with the provisions of chapter 71 of title 5. |
| (21) “School-based health center” means a facility located in an elementary or secondary |
| school licensed as a school-based health center that delivers primary and/or preventive healthcare |
| services to individuals to include, but not be limited to, students on site. |
| SECTION 3. Section 23-15-2 of the General Laws in Chapter 23-15 entitled |
| "Determination of Need for New Healthcare 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, healthcare facilities located within the state that 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 healthcare 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 healthcare equipment, if approved, will have on |
| healthcare 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 Rhode Island state department of health. |
| (4)(i) “Healthcare 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 healthcare services that 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), freestanding emergency-care facilities as defined in § 23- |
| 17-2, 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 § 23-17-2(17), (18), 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 § 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. Medical spas as defined in chapter |
| 104105 of this title 23are exempt from the requirements of this chapter15 of this title. The term |
| “healthcare 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) “Healthcare provider” means a person who is a direct provider of healthcare 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 healthcare services for |
| persons. |
| (6) “Health services” means organized program components for preventive, assessment, |
| maintenance, diagnostic, treatment, and rehabilitative services provided in a healthcare facility. |
| (7) “Health services council” means the advisory body to the Rhode Island state 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 healthcare |
| facilities and includes the entities in or through that the services are provided. |
| (9) “New healthcare equipment” means any single piece of medical equipment (and any |
| components that 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 two million two hundred fifty thousand dollars ($2,250,000); provided, |
| however, that the state agency shall exempt from review any application that proposes one-for-one |
| equipment replacement as defined in regulation. Further, beginning July 1, 2012, and each July |
| thereafter, the amount shall be adjusted by the percentage of increase in the consumer price index |
| for all urban consumers (CPI-U) as published by the United States Department of Labor Statistics |
| as of September 30 of the prior calendar year. |
| (10) “New institutional health services” means and includes: |
| (i) Construction, development, or other establishment of a new healthcare facility. |
| (ii) Any expenditure, except acquisitions of an existing healthcare facility, that will not |
| result in a change in the services or bed capacity of the healthcare facility by, or on behalf of, an |
| existing healthcare facility in excess of five million two hundred fifty thousand dollars ($5,250,000) |
| which is a capital expenditure including expenditures for predevelopment activities; provided |
| further, beginning July 1, 2012, and each July thereafter, the amount shall be adjusted by the |
| percentage of increase in the consumer price index for all urban consumers (CPI-U) as published |
| by the United States Department of Labor Statistics as of September 30 of the prior calendar year. |
| (iii) Where a person makes an acquisition by, or on behalf of, a healthcare 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 that results in the addition of a health service or that changes |
| the bed capacity of a healthcare 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 healthcare |
| facility that was not offered on a regular basis in or through the facility within the twelve-month |
| (12) period prior to the time the service would be offered, and that increases operating expenses by |
| more than one million five hundred thousand dollars ($1,500,000), 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. Further, beginning |
| July 1, 2012, and each July thereafter, the amount shall be adjusted by the percentage of increase |
| in the consumer price index for all urban consumers (CPI-U) as published by the United States |
| Department of Labor Statistics as of September 30 of the prior calendar year. |
| (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 that 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 Rhode Island state department of health. |
| (14) “To develop” means to undertake those activities that, on their completion, will result |
| in the offering of a new, institutional health service or new healthcare 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 healthcare equipment. |
| SECTION 4. This act shall take effect upon passage. |
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| LC001015/SUB A |
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