West Virginia Code 16-2D-10 – Exemptions from certificate of need
Notwithstanding § 16-2D-8 of this code, a person may provide the following health services without obtaining a certificate of need or applying to the authority for approval:
Terms Used In West Virginia Code 16-2D-10
- Ambulatory health care facility: means a facility that provides health services to noninstitutionalized and nonhomebound persons on an outpatient basis. See West Virginia Code 16-2D-2
- Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
- Authority: means the West Virginia Health Care Authority as provided in §. See West Virginia Code 16-2D-2
- Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
- Birthing center: means a short-stay ambulatory health care facility designed for low-risk births following normal uncomplicated pregnancy. See West Virginia Code 16-2D-2
- Campus: means the physical area immediately adjacent to the hospital's main buildings, other areas, and structures that are not strictly contiguous to the main buildings, but are located within 250 yards of the main buildings. See West Virginia Code 16-2D-2
- cost: includes the fair market value. See West Virginia Code 16-2D-2
- Diagnostic imaging: means the use of radiology, ultrasound, and mammography. See West Virginia Code 16-2D-2
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Forbearance: A means of handling a delinquent loan. A
- Health care facility: means a publicly or privately owned facility, agency or entity that offers or provides health services, whether a for-profit or nonprofit entity and whether or not licensed, or required to be licensed, in whole or in part. See West Virginia Code 16-2D-2
- Health services: means clinically related preventive, diagnostic, treatment or rehabilitative services. See West Virginia Code 16-2D-2
- Hospital: means a facility licensed pursuant to the provisions of §. See West Virginia Code 16-2D-2
- Inpatient: means a patient whose medical condition, safety, or health would be significantly threatened if his or her care was provided in a less intense setting than a hospital. See West Virginia Code 16-2D-2
- Offer: means the health care facility holds itself out as capable of providing, or as having the means to provide, specified health services. See West Virginia Code 16-2D-2
- Person: means an individual, trust, estate, partnership, limited liability corporation, committee, corporation, governing body, association and other organizations such as joint-stock companies and insurance companies, a state or a political subdivision or instrumentality thereof or any legal entity recognized by the state. See West Virginia Code 16-2D-2
- Physician: means an individual who is licensed to practice allopathic medicine by the Board of Medicine or licensed to practice osteopathic medicine by the Board of Osteopathic Medicine. See West Virginia Code 16-2D-2
- State: when applied to a part of the United States and not restricted by the context, includes the District of Columbia and the several territories, and the words "United States" also include the said district and territories. See West Virginia Code 2-2-10
- Telehealth: means the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. See West Virginia Code 16-2D-2
(1) The creation of a private office of one or more licensed health professionals to practice in this state pursuant to § 30-1-1 et seq. of this code;
(2) Dispensaries and first-aid stations located within business or industrial establishments maintained solely for the use of employees that does not contain inpatient or resident beds for patients or employees who generally remain in the facility for more than 24 hours;
(3) A place that provides remedial care or treatment of residents or patients conducted only for those who rely solely upon treatment by prayer or spiritual means in accordance with the creed or tenets of any recognized church or religious denomination;
(4) Telehealth;
(5) A private office practice owned or operated by one or more health professionals authorized or organized pursuant to §30-1-1 et seq. or ambulatory health care facility may offer laboratory services or diagnostic imaging to patients regardless of the cost associated with the proposal. A private office practice owned or operated by one or more health professionals authorized or organized pursuant to chapter 30 of this code which has at least seven office practice locations may acquire and utilize one fixed-site magnetic resonance imaging scanner regardless of the cost associated with the proposal. To qualify for this exemption, 75 percent of the magnetic resonance imaging scans are for the patients of the private office practice of the total magnetic resonance imaging scans performed. To qualify for this exemption 75 percent of the laboratory services are for the patients of the practice or ambulatory health care facility of the total laboratory services performed and 75 percent of diagnostic imaging services are for the patients of the practice or ambulatory health care facility of the total imaging services performed. The authority may, at any time, request from the entity information concerning the number of patients who have been provided laboratory services diagnostic imaging, or magnetic resonance imaging services;
(6) (A) Notwithstanding the provisions of §16-2D-17, any hospital that holds a valid certificate of need issued pursuant to this article, may transfer that certificate of need to a person purchasing that hospital, or all or substantially all of its assets, if the hospital is financially distressed. A hospital is financially distressed if, at the time of its purchase:
(i) It has filed a petition for voluntary bankruptcy;
(ii) It has been the subject of an involuntary petition for bankruptcy;
(iii) It is in receivership;
(iv) It is operating under a forbearance agreement with one or more of its major creditors;
(v) It is in default of its obligations to pay one or more of its major creditors and is in violation of the material, substantive terms of its debt instruments with one or more of its major creditors; or
(vi) It is insolvent: evidenced by balance sheet insolvency and/or the inability to pay its debts as they come due in the ordinary course of business.
(B) A financially distressed hospital which is being purchased pursuant to the provisions of this subsection shall give notice to the authority of the sale 30 days prior to the closing of the transaction and shall file simultaneous with that notice evidence of its financial status. The financial status or distressed condition of a hospital shall be evidenced by the filing of any of the following:
(i) A copy of a forbearance agreement;
(ii) A copy of a petition for voluntary or involuntary bankruptcy;
(iii) Written evidence of receivership, or
(iv) Documentation establishing the requirements of subparagraph (v) or (vi), paragraph (A) of this subdivision. The names of creditors may be redacted by the filing party.
(C) Any substantial change to the capacity of services offered in that hospital made subsequent to that transaction would remain subject to the requirements for the issuance of a certificate of need as otherwise set forth in this article.
(D) Any person purchasing a financially distressed hospital, or all or substantially all of its assets, that has applied for a certificate of need after January 1, 2017, shall qualify for an exemption from certificate of need;
(7) The acquisition by a qualified hospital which is party to an approved cooperative agreement as provided in section § 16-29B-28 of this code, of a hospital located within a distance of 20 highway miles of the main campus of the qualified hospital;
(8) The acquisition by a hospital of a physician practice group which owns an ambulatory surgical center as defined in this article;
(9) Hospital services performed at a hospital; and
(10) Constructing, developing, acquiring, or establishing a birthing center :Provided, That a hospital shall be deemed a trauma center, subject to the provisions of § 55-7B-9c of this code, for any and all claims arising out of any medical services provided by a hospital or physician to an individual as a result of birth complications at a birthing center.