Connecticut 2017 Regular Session Status: In Committee

SB 795 — AN ACT ESTABLISHING THE OFFICE OF HEALTH STRATEGY AND IMPROVING THE CERTIFICATE OF NEED PROGRAM.

Last action — FILE NO. 574

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    Introduced
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    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed House
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2017 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Bill Text

What changed in the latest version

74 added · 58 removed

Plain-language change summary

The revised version of SB 795 updates the responsibilities of the Office of the Lieutenant Governor by specifying oversight of the all-payers claim database program and the Health Care Cabinet. It also changes the definition of a "new hospital" to include those approved through different types of ownership transfers. Additionally, the inventory of health care facilities will now be updated every three years instead of biennially. These modifications affect how health care services and facilities are managed and reported, potentially impacting access and planning within the state’s health care system.

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General Assembly   Governor's Bill No.
General Assembly   Substitute Bill No.
795 January Session, 2017   LCO No.
795 January Session, 2017   *_____SB00795PH____032917____* AN ACT ESTABLISHING THE OFFICE OF HEALTH STRATEGY AND IMPROVING THE CERTIFICATE OF NEED PROGRAM.
3739   *03739__________* Referred to Committee on PUBLIC HEALTH   Introduced by:
  SEN.
LOONEY, 11th Dist.
SEN.
DUFF, 25th Dist.
REP.
ARESIMOWICZ, 30th Dist.
REP.
RITTER M., 1st Dist.
  AN ACT ESTABLISHING THE OFFICE OF HEALTH STRATEGY AND IMPROVING THE CERTIFICATE OF NEED PROGRAM.
(2) Directing and overseeing the (A) all-payers claim database program established pursuant to section 38-1091 of the general statutes, (B) the State Innovation Model Initiative and related successor initiatives;
(2) Directing and overseeing (A) the all-payers claim database program established pursuant to section 38-1091 of the general statutes, and (B) the State Innovation Model Initiative and related successor initiatives;
and (2) The Office of the Lieutenant Governor, relating to the (A) development of a chronic disease plan pursuant to section 19a-6q of the general statutes, (B) housing, chairing and staffing of the Health Care Cabinet pursuant to section 19a-725 of the general statutes, and (C) (i) appointment of the health information technology officer pursuant to section 19a-755 of the general statutes, and (ii) oversight of the duties of such health information technology officer as set forth in sections 17b-59, 17b-59a and 17b-59f of the general statutes.
and (2) The Office of the Lieutenant Governor, relating to the (A) development of a chronic disease plan pursuant to section 19a-6q of the general statutes, (B) housing, chairing and staffing of the Health Care Cabinet pursuant to section 19a-725 of the general statutes, and (C) (i) appointment of the health information technology officer pursuant to section 19a-755 of the general statutes, and (ii) oversight of the duties of such health information technology officer as set forth in sections 17b-59, 17b-59a and 17b-59f of the general statutes, as amended by this act.
[(12) "Nonhospital based" means located at a site other than the main campus of the hospital.] (17) "New health care facility" means a hospital or other health care facility acquired by a hospital or hospital system as it exists after the approval of an agreement pursuant to section 19a-486b, as amended by this act, or a certificate of need application for a transfer of ownership;
[(12) "Nonhospital based" means located at a site other than the main campus of the hospital.] (17) "New hospital" means a hospital as it exists after the approval of an agreement pursuant to section 19a-486b, as amended by this act, or a certificate of need application for a transfer of ownership of a hospital;
[(c)] (b) For purposes of [conducting the state-wide health care facility utilization study and] preparing the state-wide health care facilities and services plan, the office shall establish and maintain an inventory of all health care facilities, the equipment identified in [subdivisions (9) and (10)] subdivision (9) of subsection (a) of section 19a-638, as amended by this act, and services in the state, including health care facilities that are exempt from certificate of need requirements under subsection (b) of section 19a-638, as amended by this act.
[(c)] (b) For purposes of [conducting the state-wide health care facility utilization study and] preparing the state-wide health care facilities and services plan, the office shall establish and maintain an inventory of all health care facilities, the equipment identified in [subdivisions (9) and (10)] subdivision (7) of subsection (a) of section 19a-638, as amended by this act, and services in the state, including health care facilities that are exempt from certificate of need requirements under subsection (b) of section 19a-638, as amended by this act.
(1) The establishment of a new [health care facility] hospital, freestanding emergency department or outpatient surgical facility;
(1) The establishment of a new [health care facility] hospital, freestanding emergency department or outpatient surgical facility, except as provided in section 19a-639e, as amended by this act;
(2) A transfer of ownership of a health care facility to another entity that is not a hospital or hospital system, except as provided by section 19a-493b;
(2) A transfer of ownership of a health care facility;
(3) A transfer of ownership of a health care facility or large group practice to a hospital or hospital system;
(3) A transfer of ownership of a hospital to another hospital, hospital system or other entity;
(4) A transfer of ownership of a hospital to another hospital, hospital system or other entity;
[(3)] (4) A transfer of ownership of a large group practice to any entity other than a (A) physician, or (B) group of two or more physicians, legally organized in a partnership, professional corporation or limited liability company formed to render professional services and not employed by or an affiliate of any hospital, medical foundation, insurance company or other similar entity;
[(3)] (5) A transfer of ownership of a large group practice to any entity other than a (A) physician, or (B) group of two or more physicians, legally organized in a partnership, professional corporation or limited liability company formed to render professional services and not employed by or an affiliate of any hospital, medical foundation, insurance company or other similar entity;
[(4) The establishment of a freestanding emergency department;] (5) The termination of an emergency department or inpatient or outpatient services offered by a hospital, [including, but not limited to, the termination by a short-term acute care general hospital or children's hospital of inpatient and outpatient mental health and substance abuse services] hospital system or other facility or institution operated by the state that provides services that are eligible for reimbursement under Title XVIII or XIX of the federal Social Security Act, 42 USC 301, as amended from time to time, except (A) the termination of services due to insufficient patient volume or lack of available practitioners to support the effective delivery of care that is subject to the termination request process set forth in section 19a-639e, as amended by this act, and (B) the termination of services for which the Department of Public health has requested the hospital to relinquish its license;
[(4) The establishment of a freestanding emergency department;] [(5)] (6) The termination of an emergency department or inpatient or outpatient services offered by a hospital, [including, but not limited to, the termination by a short-term acute care general hospital or children's hospital of inpatient and outpatient mental health and substance abuse services] hospital system or other facility or institution operated by the state that provides services that are eligible for reimbursement under Title XVIII or XIX of the federal Social Security Act, 42 USC 301, as amended from time to time, except (A) the termination of services due to insufficient patient volume or lack of available practitioners to support the effective delivery of care that is subject to the termination request process set forth in section 19a-639e, as amended by this act, and (B) the termination of services for which the Department of Public health has requested the hospital to relinquish its license;
(8) The termination of an emergency department by a short-term acute care general hospital;
(8) The termination of an emergency department by a short-term acute care general hospital;] [(9)] (6) The establishment of cardiac services, including inpatient and outpatient cardiac catheterization, interventional cardiology and cardiovascular surgery;
(9) The establishment of cardiac services, including inpatient and outpatient cardiac catheterization, interventional cardiology and cardiovascular surgery;] (7) The relocation of a health care facility, except the relocation of a health care facility to an area identified in the state-wide health care facilities and services plan as underserved or having reduced access to specific types of health care services, provided such entity proposing such relocation notifies the office of such relocation pursuant to section 19a-639c, as amended by this act;
and [(10)] (7) The acquisition of scanners that utilize imaging techniques, including, but not limited to, computed tomography, [scanners,] magnetic resonance imaging, [scanners,] positron emission tomography, [scanners or] positron emission tomography-computed tomography [scanners,] or single-photon emission computed tomography by any person, physician, provider [, short-term acute care general hospital or children's hospital, except (A) as provided for in subdivision (22) of subsection (b) of this section, and (B) a certificate of need issued by the office shall not be required where such scanner is a replacement for a scanner that was previously acquired through certificate of need approval or a certificate of need determination;] or hospital that filed a request pursuant to subsection (b) of section 19a-639e, as amended by this act, and did not sufficiently demonstrate to the satisfaction of the office that methods will be employed to minimize the practice of patient referrals in which the referring provider stands to financially gain from such referral and that Medicaid recipients and indigent persons will have access to services provided utilizing the acquired equipment.
(8) The reduction of inpatient or outpatient services by a hospital or hospital system;
and [(10)] (9) The acquisition of scanners that utilize imaging techniques, including, but not limited to, computed tomography, [scanners,] magnetic resonance imaging, [scanners,] positron emission tomography, [scanners or] positron emission tomography-computed tomography [scanners,] or single-photon emission computed tomography by any person, physician, provider [, short-term acute care general hospital or children's hospital, except (A) as provided for in subdivision (22) of subsection (b) of this section, and (B) a certificate of need issued by the office shall not be required where such scanner is a replacement for a scanner that was previously acquired through certificate of need approval or a certificate of need determination;] or hospital that filed a request pursuant to subsection (b) of section 19a-639e, as amended by this act, and did not sufficiently demonstrate to the satisfaction of the office that methods will be employed to minimize the practice of patient referrals in which the referring provider stands to financially gain from such referral and that Medicaid recipients and indigent persons will have access to services provided utilizing the acquired equipment.
(2) The establishment of offices by a licensed private practitioner, whether for individual or group practice, except when a certificate of need is required in accordance with the requirements of section 19a-493b or subdivision (3), [(10) or (11)] (5) or (9) of subsection (a) of this section;
(2) The establishment of offices by a licensed private practitioner, whether for individual or group practice, except when a certificate of need is required in accordance with the requirements of section 19a-493b or subdivision [(3), (10) or (11)] (4) or (7) of subsection (a) of this section;
(a) In any deliberations involving a certificate of need application filed pursuant to subdivisions (1), (2), (5) and (9) of subsection (a) of section 19a-638, as amended by this act, the office shall take into consideration and make written findings concerning each of the following guidelines and principles, as applicable:
(a) In any deliberations involving a certificate of need application filed pursuant to subdivisions (1), (2), (4), (6) and (7) of subsection (a) of section 19a-638, as amended by this act, the office shall take into consideration and make written findings concerning each of the following guidelines and principles, as applicable:
and (G) "Transfer of ownership of a hospital" means a transfer that impacts or changes the governance or controlling body of a hospital, including, but not limited to, all affiliations, mergers or any sale or transfer of net assets of a hospital and for which a certificate of need application or a certificate of need determination letter is filed on or after December 1, 2015.] (b) In any deliberations involving a certificate of need application filed pursuant to subdivisions (6), (7) and (8) of subsection (a) of section 19a-638, as amended by this act, the office shall take into consideration and make written findings concerning each of the following guidelines and principles, as applicable:
and (G) "Transfer of ownership of a hospital" means a transfer that impacts or changes the governance or controlling body of a hospital, including, but not limited to, all affiliations, mergers or any sale or transfer of net assets of a hospital and for which a certificate of need application or a certificate of need determination letter is filed on or after December 1, 2015.] (b) In any deliberations involving a certificate of need application filed pursuant to subdivision (5) of subsection (a) of section 19a-638, as amended by this act, the office shall take into consideration and make written findings concerning each of the following guidelines and principles, as applicable:
[(2)] (c) In any deliberations involving a certificate of need application filed pursuant to subdivisions (3) and (4) of subsection (a) of section 19a-638, [that involves the transfer of ownership of a hospital, the office shall, in addition to the guidelines and principles set forth in subsection (a) of this section and those prescribed through regulation pursuant to subsection (c) of this section,] as amended by this act, the office shall take into consideration and make written findings concerning each of the following guidelines and principles, as applicable:
[(2)] (c) In any deliberations involving a certificate of need application filed pursuant to subdivision (3) of subsection (a) of section 19a-638, [that involves the transfer of ownership of a hospital, the office shall, in addition to the guidelines and principles set forth in subsection (a) of this section and those prescribed through regulation pursuant to subsection (c) of this section,] as amended by this act, the office shall take into consideration and make written findings concerning each of the following guidelines and principles, as applicable:
[and] [(B)] (2) Whether the plan submitted pursuant to section 19a-639a, as amended by this act, demonstrates, in a manner consistent with this chapter, how health care services will be provided by the new [hospital] health care facility for the first three years following the transfer of ownership of the hospital, including any consolidation, reduction, elimination or expansion of existing services or introduction of new services.
[and] [(B)] (2) Whether the plan submitted pursuant to section 19a-639a, as amended by this act, demonstrates, in a manner consistent with this chapter, how health care services will be provided by the new hospital for the first three years following the transfer of ownership of the hospital, including any consolidation, reduction, elimination or expansion of existing services or introduction of new services;
(3) Whether the proposed project is aligned with the state-wide health care facilities and services plan established under section 19a-634, as amended by this act, including whether the proposed project will serve individuals in geographic areas that are underserved or have reduced access to specific types of health care services;
[.] (3) Whether the proposed project is aligned with the state-wide health care facilities and services plan established under section 19a-634, as amended by this act, including whether the proposed project will serve individuals in geographic areas that are underserved or have reduced access to specific types of health care services;
[(3)] (d) The office shall deny any certificate of need application involving a transfer of ownership of a hospital or a transfer of ownership of any other health care facility or large group practice to a hospital or hospital system unless the commissioner finds that the affected community will be assured of continued access to high quality and affordable health care after accounting for any proposed change impacting hospital staffing.
[(3)] (d) The office shall deny any certificate of need application involving a transfer of ownership of a hospital unless the commissioner finds that the affected community will be assured of continued access to high quality and affordable health care after accounting for any proposed change impacting hospital staffing.
[(4)] (e) The office may deny any certificate of need application involving a transfer of ownership of a hospital or a transfer of ownership of any other health care facility or large group practice to a hospital or hospital system subject to a cost and market impact review pursuant to section 19a-639f, as amended by this act, if the commissioner finds that [(A)] (1) the affected community will not be assured of continued access to high quality and affordable health care after accounting for any consolidation in the hospital and health care market that may lessen health care provider diversity, consumer choice and access to care, and [(B)] (2) any likely increases in the prices for health care services or total health care spending in the state may negatively impact the affordability of care.
[(4)] (e) The office may deny any certificate of need application involving a transfer of ownership of a hospital subject to a cost and market impact review pursuant to section 19a-639f, as amended by this act, if the commissioner finds that [(A)] (1) the affected community will not be assured of continued access to high quality and affordable health care after accounting for any consolidation in the hospital and health care market that may lessen health care provider diversity, consumer choice and access to care, and [(B)] (2) any likely increases in the prices for health care services or total health care spending in the state may negatively impact the affordability of care.
The transacting parties or the new hospital shall have the right to make a request to the office for an amendment to, or relief from, any condition based on changed circumstances, hardship or for other good cause.] (f) In deliberations, as described in subsection (a) of this section, there shall be a presumption in favor of approving the certificate of need application for a transfer of ownership of a large group practice, as described in subdivision (5) of subsection (a) of section 19a-638, as amended by this act, when an offer was made in response to a request for proposal or similar voluntary offer for sale.
The transacting parties or the new hospital shall have the right to make a request to the office for an amendment to, or relief from, any condition based on changed circumstances, hardship or for other good cause.] (f) In deliberations, as described in subsection (a) of this section, there shall be a presumption in favor of approving the certificate of need application for a transfer of ownership of a large group practice, as described in subdivision (4) of subsection (a) of section 19a-638, as amended by this act, when an offer was made in response to a request for proposal or similar voluntary offer for sale.
[(e)] (g) (1) If the certificate of need application (A) involves the transfer of ownership of a hospital [, (B) the purchaser is a hospital, as defined in section 19a-490, whether located within or outside the state, that had net patient revenue for fiscal year 2013 in an amount greater than one billion five hundred million dollars or a hospital system, as defined in section 19a-486i, whether located within or outside the state, that had net patient revenue for fiscal year 2013 in an amount greater than one billion five hundred million dollars, or any person that is organized or operated for profit] or the transfer of ownership of any other health care facility or large group practice to a hospital or hospital system, and [(C)] (B) such application is approved, the office shall hire an independent consultant, who shall have no previous financial interest with the hospital or hospital system, or any affiliate of the hospital or hospital system, no previous sanctions and no adverse decisions regarding monitoring activities, to serve as a post-transfer compliance reporter for a period of three years after completion of the transfer of ownership.
[(e)] (g) (1) If the certificate of need application (A) involves the transfer of ownership of a hospital, (B) the purchaser is a hospital, as defined in section 19a-490, whether located within or outside the state, that had net patient revenue for fiscal year 2013 in an amount greater than one billion five hundred million dollars or a hospital system, as defined in section 19a-486i, whether located within or outside the state, that had net patient revenue for fiscal year 2013 in an amount greater than one billion five hundred million dollars, or any person that is organized or operated for profit, and (C) such application is approved, the office shall hire an independent consultant, who shall have no previous financial interest with the hospital or hospital system, or any affiliate of the hospital or hospital system, no previous sanctions and no adverse decisions regarding monitoring activities, to serve as a post-transfer compliance reporter for a period of three years after completion of the transfer of ownership of the hospital.
[of the hospital.] Such reporter shall, at a minimum:
Such reporter shall, at a minimum:
(i) Meet with representatives of the purchaser, [the] such new [hospital] health care facility or large group practice, as applicable, and members of the affected community served by [the] such new [hospital] health care facility or large group practice not less than quarterly;
(i) Meet with representatives of the purchaser, the new hospital and members of the affected community served by the new hospital not less than quarterly;
and (ii) report to the office not less than quarterly concerning (I) efforts the purchaser and representatives of [the] such new [hospital] health care facility or large group practice have taken to comply with any conditions the office placed on the approval of the certificate of need application and plans for future compliance, and (II) community benefits and uncompensated care provided by [the] such new [hospital] health care facility or large group practice.
and (ii) report to the office not less than quarterly concerning (I) efforts the purchaser and representatives of the new hospital have taken to comply with any conditions the office placed on the approval of the certificate of need application and plans for future compliance, and (II) community benefits and uncompensated care provided by the new hospital.
The purchaser shall hold a public hearing in the municipality in which the new [hospital] health care facility or large group practice is located not less than annually during the reporting period to provide for public review and comment on the reporter's reports and findings.
The purchaser shall hold a public hearing in the municipality in which the new hospital is located not less than annually during the reporting period to provide for public review and comment on the reporter's reports and findings.
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In addition to any information requested by the office, if the application involves the transfer of ownership of a hospital or the transfer of ownership of a health care facility or large group practice to a hospital or hospital system, as defined in section [19a-639] 19a-630, as amended by this act, the applicant shall submit to the office (A) a plan demonstrating how health care services will be provided by the new [hospital] health care facility or large group practice for the first three years following the transfer of ownership, [of the hospital,] including any consolidation, reduction, elimination or expansion of existing services or introduction of new services, and (B) the names of persons currently holding a position with the [hospital] health care facility or large group practice to be purchased or the purchaser, as defined in section [19a-639] 19a-630, as amended by this act, as an officer, director, board member or senior manager, whether or not such person is expected to hold a position with the [hospital] health care facility or large group practice after completion of the transfer of ownership [of the hospital] and any salary, severance, stock offering or any financial gain, current or deferred, such person is expected to receive as a result of, or in relation to, [the] such transfer of ownership.
In addition to any information requested by the office, if the application involves the transfer of ownership of a hospital, as defined in section [19a-639] 19a-630, as amended by this act, the applicant shall submit to the office (A) a plan demonstrating how health care services will be provided by the new hospital for the first three years following the transfer of ownership of the hospital, including any consolidation, reduction, elimination or expansion of existing services or introduction of new services, and (B) the names of persons currently holding a position with the hospital to be purchased or the purchaser, as defined in section [19a-639] 19a-630, as amended by this act, as an officer, director, board member or senior manager, whether or not such person is expected to hold a position with the hospital after completion of the transfer of ownership [of the hospital] and any salary, severance, stock offering or any financial gain, current or deferred, such person is expected to receive as a result of, or in relation to, the transfer of ownership of the hospital.
[of the hospital.] (2) The applicant shall, not later than sixty days after the date of the office's request, submit any requested information and any information required under this subsection to the office.
(2) The applicant shall, not later than sixty days after the date of the office's request, submit any requested information and any information required under this subsection to the office.
The review period for a completed application that involves a transfer of a large group practice, as described in subdivision [(3)] (5) of subsection (a) of section 19a-638, as amended by this act, when the offer was made in response to a request for proposal or similar voluntary offer for sale, shall be sixty days from the date on which the office posts notice on its Internet web site.
The review period for a completed application that involves a transfer of a large group practice, as described in subdivision [(3)] (4) of subsection (a) of section 19a-638, as amended by this act, when the offer was made in response to a request for proposal or similar voluntary offer for sale, shall be sixty days from the date on which the office posts notice on its Internet web site.
(e) Except as provided in this subsection, the office shall hold a public hearing on a properly filed and completed certificate of need application if three or more individuals or an individual representing an entity with five or more people submits a request, in writing, that a public hearing be held on the application.
(e) [Except as provided in this subsection, the] The office shall hold a public hearing on a properly filed and completed certificate of need application if three or more individuals or an individual representing an entity with five or more people submits a request, in writing, that a public hearing be held on the application.
For a properly filed and completed certificate of need application involving a transfer of ownership of a large group practice, as described in subdivision [(3)] (5) of subsection (a) of section 19a-638, as amended by this act, when an offer was made in response to a request for proposal or similar voluntary offer for sale, a public hearing shall be held if twenty-five or more individuals or an individual representing twenty-five or more people submits a request, in writing, that a public hearing be held on the application.
For a properly filed and completed certificate of need application involving a transfer of ownership of a large group practice, as described in subdivision [(3)] (4) of subsection (a) of section 19a-638, as amended by this act, when an offer was made in response to a request for proposal or similar voluntary offer for sale, a public hearing shall be held if twenty-five or more individuals or an individual representing twenty-five or more people submits a request, in writing, that a public hearing be held on the application.
(f) (1) The office shall hold a public hearing [with respect to each] on a properly filed and completed certificate of need application [filed pursuant to section 19a-638 after December 1, 2015,] that concerns any transfer of ownership [involving] of a hospital of any other health care facility or large group practice to a hospital or hospital system.
(f) (1) The office shall hold a public hearing [with respect to each] on a properly filed and completed certificate of need application [filed pursuant to section 19a-638 after December 1, 2015,] that concerns any transfer of ownership [involving] of a hospital.
Such hearing shall be held in the municipality in which the hospital, other health care facility or large group practice that is the subject of the application is located.
Such hearing shall be held in the municipality in which the hospital that is the subject of the application is located.
(g) If the certificate of need application involves the transfer of ownership of a hospital or the transfer of ownership of any other health care facility or large group practice to a hospital or hospital system, the applicant shall include in a single application all information related to all supplemental transactions associated with such transfer of ownership that would otherwise require a separate certificate of need application.
(g) If the certificate of need application involves the transfer of ownership of a hospital, the applicant shall include in a single application all information related to all supplemental transactions associated with such transfer of ownership that would otherwise require a separate certificate of need application.
(a) Any health care facility that proposes to relocate a facility to an area identified in the state-wide health care facilities and services plan as underserved or having reduced access to specific types of health care services shall submit a [letter] determination request to the office [, as described in subsection (c) of section 19a-638.
(a) Any health care facility that proposes to relocate a facility shall submit a [letter] determination request to the office [, as described in subsection (c) of section 19a-638.
In addition to the requirements prescribed in said subsection (c), in such letter the health care facility shall demonstrate] that describes the project and demonstrates to the satisfaction of the office that the [population served by the health care facility and the payer mix will not substantially change as a result of the facility's proposed relocation] proposed area of relocation is identified in the state-wide health care facilities and services plan as underserved or having reduced access to specific types of health care services in such plan.
In addition to the requirements prescribed in said subsection (c), in such letter the health care facility shall demonstrate] that describes the project and demonstrates to the satisfaction of the office that the population served by the health care facility and the payer mix will not substantially change as a result of the facility's proposed relocation.
If the facility is unable to demonstrate that the proposed area of relocation is identified in the state-wide health care facilities and services plan as underserved or having reduced access to specific types of health care services in such plan to the satisfaction of the office, [that the population served and the payer mix will not substantially change as a result of the proposed relocation,] the health care facility shall apply for certificate of need approval pursuant to subdivision [(1)] (7) of subsection (a) of section 19a-638, as amended by this act, in order to effectuate the proposed relocation.
If the facility is unable to demonstrate to the satisfaction of the office that the population served and the payer mix will not substantially change as a result of the proposed relocation, the health care facility shall apply for certificate of need approval pursuant to subdivision (1) of subsection (a) of section 19a-638, as amended by this act, in order to effectuate the proposed relocation.
(a) [Unless otherwise required to file a certificate of need application pursuant to the provisions of subsection (a) of section 19a-638, any health care facility that proposes to terminate a service that was authorized pursuant to a certificate of need issued under this chapter shall file a modification request with] Any hospital or hospital system proposing to terminate inpatient or outpatient services due to insufficient patient volume or the lack of practitioners to support the effective delivery of care, as specified in subdivision (6) of subsection (a) of section 19a-638, as amended by this act, shall submit a determination request to the office not later than sixty days prior to the proposed date of the termination of the service.
(a) [Unless otherwise required to file a certificate of need application pursuant to the provisions of subsection (a) of section 19a-638, any health care facility that proposes to terminate a service that was authorized pursuant to a certificate of need issued under this chapter shall file a modification request with] Any hospital or hospital system proposing to terminate or reduce inpatient or outpatient services due to insufficient patient volume or the lack of practitioners to support the effective delivery of care, as specified in subdivision (5) of subsection (a) of section 19a-638, as amended by this act, shall submit a determination request to the office not later than sixty days prior to the proposed date of [the] such termination or reduction of the service.
Such request shall include (1) the date on which the service or services will be terminated by the hospital or hospital system, (2) documentation that demonstrates that the hospital or hospital system is experiencing insufficient patient volume or lack of practitioners for the service, resulting in such hospital or hospital system being unable to support effective delivery of care, and (3) whether the termination of service will occur in a geographic area that has been identified in the state-wide health care facilities and services plan as being underserved or having reduced access to specific types of health care services.
Such request shall include (1) the date on which the service or services will be terminated or reduced by the hospital or hospital system, (2) documentation that demonstrates that the hospital or hospital system is experiencing insufficient patient volume or lack of practitioners for the service, resulting in such hospital or hospital system being unable to support effective delivery of care, and (3) whether the termination or reduction of service will occur in a geographic area that has been identified in the state-wide health care facilities and services plan as being underserved or having reduced access to specific types of health care services.
Any hospital or hospital system that is unable to demonstrate to the satisfaction of the office that the proposed termination is due to insufficient patient volume or the lack of practitioners to support the effective delivery of care shall be required to file a certificate of need pursuant to subsection (a) of section 19a-638, as amended by this act.
Any hospital or hospital system that is unable to demonstrate to the satisfaction of the office that the proposed termination or reduction is due to insufficient patient volume or the lack of practitioners to support the effective delivery of care shall be required to file a certificate of need pursuant to subsection (a) of section 19a-638, as amended by this act.
(b) Unless otherwise required to file a certificate of need application pursuant to the provisions of subsection (a) of section 19a-638, any health care facility that proposes to terminate all services offered by such facility, that were authorized pursuant to one or more certificates of need issued under this chapter, shall provide notification to the office not later than sixty days prior to the termination of services and such facility shall surrender its certificate of need not later than thirty days prior to the termination of services.] (b) Any person, physician, provider or hospital proposing to acquire a scanner that utilizes imaging techniques including, but not limited to, computed tomography, magnetic resonance imaging, positron emission tomography, positron emission tomography-computed tomography or single-photon emission computed tomography shall submit a determination request to the office not later than sixty days prior to the proposed date of the acquisition of the equipment, unless such proposed acquisition is for the purpose of replacing an existing scanner with a similar scanner, if such existing scanner was acquired through a certificate of need approval or a certificate of need determination, provided a person, physician, provider or hospital notifies the office of the date on which the scanner is replaced and the disposition of the replaced scanner.
(b) Unless otherwise required to file a certificate of need application pursuant to the provisions of subsection (a) of section 19a-638, any health care facility that proposes to terminate all services offered by such facility, that were authorized pursuant to one or more certificates of need issued under this chapter, shall provide notification to the office not later than sixty days prior to the termination of services and such facility shall surrender its certificate of need not later than thirty days prior to the termination of services.] (b) Any person, physician, provider or hospital proposing to acquire a scanner that utilizes imaging techniques, including, but not limited to, computed tomography, magnetic resonance imaging, positron emission tomography, positron emission tomography-computed tomography or single-photon emission computed tomography shall submit a determination request to the office not later than sixty days prior to the proposed date of the acquisition of the equipment, unless such proposed acquisition is for the purpose of replacing an existing scanner with a similar scanner, if such existing scanner was acquired through a certificate of need approval or a certificate of need determination, provided a person, physician, provider or hospital notifies the office of the date on which the scanner is replaced and the disposition of the replaced scanner.
(c) Any person proposing to establish a new hospital, new freestanding emergency department or new outpatient surgical facility in areas identified in the state-wide health care facilities and services plan as underserved or having reduced access to specific types of health care services shall submit a determination request to the office not later than sixty days prior to the proposed establishment of such new facility.
(c) Any person proposing to establish a new hospital, new freestanding emergency department or new outpatient surgical facility in areas identified in the state-wide health care facilities and services plan as underserved or having reduced access to specific types of health care services shall submit a determination request to the office not later than sixty days prior to the proposed establishment of such new health care facility.
Such request shall include (1) the date on which such new health care facility is proposed to be operational, (2) a demonstration that the new health care facility will be located in a geographic area that has been identified in the state-wide health care facilities and services plan as being underserved or having reduced access to specific types of health care services, and (3) a demonstration that Medicaid recipients and indigent persons will have access to the services provided utilizing the equipment acquired.
Such request shall include (1) the date on which such new health care facility is proposed to be operational, (2) a demonstration that the new health care facility will be located in a geographic area that has been identified in the state-wide health care facilities and services plan as being underserved or having reduced access to specific types of health care services, and (3) a demonstration that Medicaid recipients and indigent persons will have access to the services provided.
[(a)] (b) The Office of Healthcare Access division within the Department of Public Health shall conduct a cost and market impact review in each case where (1) an application for a certificate of need filed pursuant to section 19a-638, as amended by this act, involves the transfer of ownership of a hospital, as defined in section [19a-639, and (2) the purchaser is a hospital, as defined in section 19a-490, whether located within or outside the state, that had net patient revenue for fiscal year 2013 in an amount greater than one billion five hundred million dollars, or a hospital system, as defined in section 19a-486i, whether located within or outside the state, that had net patient revenue for fiscal year 2013 in an amount greater than one billion five hundred million dollars or any person that is organized or operated for profit] 19a-630, as amended by this act, or (2) an application for a certificate of need filed pursuant to section 19a-638, as amended by this act, involves the transfer of ownership of a health care facility, other than a hospital or a large group practice to a hospital or hospital system.
[(a)] (b) The Office of Healthcare Access division within the Department of Public Health shall conduct a cost and market impact review in each case where (1) an application for a certificate of need filed pursuant to section 19a-638, as amended by this act, involves the transfer of ownership of a hospital, [as defined in section 19a-639,] and (2) the purchaser is a hospital, [as defined in section 19a-490,] whether located within or outside the state, that had net patient revenue for fiscal year 2013 in an amount greater than one billion five hundred million dollars, or a hospital system, [as defined in section 19a-486i,] whether located within or outside the state, that had net patient revenue for fiscal year 2013 in an amount greater than one billion five hundred million dollars or any person that is organized or operated for profit.
[(b)] (c) Not later than twenty-one days after receipt of a properly filed certificate of need application involving the transfer of ownership of a hospital [filed on or after December 1, 2015, as described in subsection (a) of this section] or the transfer of ownership of a health care facility, other than a hospital, or large group practice to a hospital or hospital system, the office shall initiate such cost and market impact review by sending the transacting parties a written notice that shall contain a description of the basis for the cost and market impact review as well as a request for information and documents.
[(b)] (c) Not later than twenty-one days after receipt of a properly filed certificate of need application involving the transfer of ownership of a hospital [filed on or after December 1, 2015, as described in subsection (a) of this section,] the office shall initiate such cost and market impact review by sending the transacting parties a written notice that shall contain a description of the basis for the cost and market impact review as well as a request for information and documents.
Such response shall include, but need not be limited to, any information or documents requested by the office concerning the transfer of ownership.
Such response shall include, but need not be limited to, any information or documents requested by the office concerning the transfer of ownership of the hospital.
[of the hospital.] The office shall have the powers with respect to the cost and market impact review as provided in section 19a-633.
The office shall have the powers with respect to the cost and market impact review as provided in section 19a-633.
(1) Currently has or, following the proposed transfer of operations, [of the hospital,] is likely to have a dominant market share for the services the transacting party provides;
(1) Currently has or, following the proposed transfer of operations of the hospital, is likely to have a dominant market share for the services the transacting party provides;
and (2) (A) currently charges or, following the proposed transfer of operations, [of the hospital,] is likely to charge prices for services that are materially higher than the median prices charged by all other health care providers for the same services in the same market, or (B) currently has or, following the proposed transfer of operations, [of a hospital,] is likely to have a health status adjusted total medical expense that is materially higher than the median total medical expense for all other health care providers for the same service in the same market.
and (2) (A) currently charges or, following the proposed transfer of operations of the hospital, is likely to charge prices for services that are materially higher than the median prices charged by all other health care providers for the same services in the same market, or (B) currently has or, following the proposed transfer of operations of a hospital, is likely to have a health status adjusted total medical expense that is materially higher than the median total medical expense for all other health care providers for the same service in the same market.
[(g)] (h) Nothing in this section shall prohibit a transfer of ownership [of a hospital] as described in subsection (b) of this section, provided any such proposed transfer shall not be completed (1) less than thirty days after the office has issued a final report on a cost and market impact review, if such review is required, or (2) while any action brought by the Attorney General pursuant to subsection [(h)] (i) of this section is pending and before a final judgment on such action is issued by a court of competent jurisdiction.
[(g)] (h) Nothing in this section shall prohibit a transfer of ownership of a hospital, provided any such proposed transfer shall not be completed (1) less than thirty days after the office has issued a final report on a cost and market impact review, if such review is required, or (2) while any action brought by the Attorney General pursuant to subsection [(h)] (i) of this section is pending and before a final judgment on such action is issued by a court of competent jurisdiction.
[(h)] (i) After the office refers a final report on a transfer of ownership [of a hospital] as described in subsection (b) of this section to the Attorney General under subsection (f) of this section, the Attorney General may:
[(h)] (i) After the office refers a final report on a transfer of ownership of a hospital to the Attorney General under subsection [(f)] (g) of this section, the Attorney General may:
(1) Conduct an investigation to determine whether the transacting parties engaged, or, as a result of completing the transfer of ownership, [of the hospital,] are expected to engage in unfair methods of competition, anti-competitive behavior or other conduct in violation of chapter 624 or 735a or any other state or federal law;
(1) Conduct an investigation to determine whether the transacting parties engaged, or, as a result of completing the transfer of ownership of the hospital, are expected to engage in unfair methods of competition, anti-competitive behavior or other conduct in violation of chapter 624 or 735a or any other state or federal law;
Such purchaser] Upon the filing of an application involving the transfer of ownership, the purchaser shall establish an escrow account pursuant to a formal escrow agreement provided by the Office of Health Care Access for the purpose of paying the bills for services provided by the independent consultant.
Such purchaser] Upon the filing of an application involving the transfer of ownership of a hospital, the purchaser shall establish an escrow account pursuant to a formal escrow agreement provided by the Office of Health Care Access for the purpose of paying the bills for services provided by the independent consultant.
(a) Any facility, as defined in subsection (a) of section 17b-352, which proposes [(1) a capital expenditure] to incur (1) capital expenditures exceeding one million dollars, which increases facility square footage by more than five thousand square feet or five per cent of the existing square footage, whichever is greater, [(2) a capital expenditure] or (2) capital expenditures exceeding two million dollars, [or (3) the acquisition of major medical equipment requiring a capital expenditure in excess of four hundred thousand dollars, including the leasing of equipment or space,] shall submit a request for approval of such expenditure, with such information as the department requires, to the Department of Social Services.
(a) Any facility, as defined in subsection (a) of section 17b-352, as amended by this act, which proposes [(1) a capital expenditure] to incur (1) capital expenditures exceeding one million dollars, which increases facility square footage by more than five thousand square feet or five per cent of the existing square footage, whichever is greater, [(2) a capital expenditure] or (2) capital expenditures exceeding two million dollars, [or (3) the acquisition of major medical equipment requiring a capital expenditure in excess of four hundred thousand dollars, including the leasing of equipment or space,] shall submit a request for approval of such expenditure, with such information as the department requires, to the Department of Social Services.
(B) to apply to a potential nonresident patient the financial eligibility criteria applied to a potential resident of the facility pursuant to said subsection (b);
(B) to apply to a potential nonresident patient the financial eligibility criteria applied to a potential resident of the facility;
and (C) to at least annually screen each nonresident patient to ensure the maintenance of assets, income and insurance sufficient to cover the cost of at least forty-two months of nursing facility care.
[pursuant to said subsection (b);] and (C) to at least annually screen each nonresident patient to ensure the maintenance of assets, income and insurance sufficient to cover the cost of at least forty-two months of nursing facility care.
Subsection (c) of section 19a-654 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017):
Subsection (c) of section 19a-654 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2017):
Subsection (b) of section 19a-486b of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2017):
Subsection (b) of section 19a-486b of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2017):
Sections 17b-354b and 17b-354c are repealed.
Section 17b-59f of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2017):
(a) There shall be a State Health Information Technology Advisory Council to advise the Health Information Technology Officer, designated in accordance with section 19a-755, in developing priorities and policy recommendations for advancing the state's health information technology and health information exchange efforts and goals and to advise the Health Information Technology Officer in the development and implementation of the state-wide health information technology plan and standards and the State-wide Health Information Exchange, established pursuant to section 17b-59d.
The advisory council shall also advise the Health Information Technology Officer regarding the development of appropriate governance, oversight and accountability measures to ensure success in achieving the state's health information technology and exchange goals.
(b) The council shall consist of the following members:
(1) The Health Information Technology Officer, appointed in accordance with section 19a-755, or the Health Information Technology Officer's designee;
(2) The Commissioners of Social Services, Mental Health and Addiction Services, Children and Families, Correction, Public Health and Developmental Services, or the commissioners' designees;
(3) The Chief Information Officer of the state, or the Chief Information Officer's designee;
(4) The chief executive officer of the Connecticut Health Insurance Exchange, or the chief executive officer's designee;
(5) The director of the state innovation model initiative program management office, or the director's designee;
(6) The chief information officer of The University of Connecticut Health Center, or said chief information officer's designee;
(7) The Healthcare Advocate, or the Healthcare Advocate's designee;
(8) The Comptroller, or the Comptroller's designee;
[(8)] (9) Five members appointed by the Governor, one each of whom shall be (A) a representative of a health system that includes more than one hospital, (B) a representative of the health insurance industry, (C) an expert in health information technology, (D) a health care consumer or consumer advocate, and (E) a current or former employee or trustee of a plan established pursuant to subdivision (5) of subsection (c) of 29 USC 186;
[(9)] (10) Three members appointed by the president pro tempore of the Senate, one each who shall be (A) a representative of a federally qualified health center, (B) a provider of behavioral health services, and (C) a representative of the Connecticut State Medical Society;
[(10)] (11) Three members appointed by the speaker of the House of Representatives, one each who shall be (A) a technology expert who represents a hospital system, as defined in section 19a-486i, (B) a provider of home health care services, and (C) a health care consumer or a health care consumer advocate;
[(11)] (12) One member appointed by the majority leader of the Senate, who shall be a representative of an independent community hospital;
[(12)] (13) One member appointed by the majority leader of the House of Representatives, who shall be a physician who provides services in a multispecialty group and who is not employed by a hospital;
[(13)] (14) One member appointed by the minority leader of the Senate, who shall be a primary care physician who provides services in a small independent practice;
[(14)] (15) One member appointed by the minority leader of the House of Representatives, who shall be an expert in health care analytics and quality analysis;
[(15)] (16) The president pro tempore of the Senate, or the president's designee;
[(16)] (17) The speaker of the House of Representatives, or the speaker's designee;
[(17)] (18) The minority leader of the Senate, or the minority leader's designee;
and [(18)] (19) The minority leader of the House of Representatives, or the minority leader's designee.
(c) Any member appointed or designated under subdivisions [(9)] (10) to [(18)] (19), inclusive, of subsection (b) of this section may be a member of the General Assembly.
(d) The Health Information Technology Officer, appointed in accordance with section 19a-755, shall serve as a chairperson of the council.
The council shall elect a second chairperson from among its members, who shall not be a state official.
The terms of the members shall be coterminous with the terms of the appointing authority for each member and subject to the provisions of section 4-1a.
If any vacancy occurs on the council, the appointing authority having the power to make the appointment under the provisions of this section and shall appoint a person in accordance with the provisions of this section.
A majority of the members of the council shall constitute a quorum.
Members of the council shall serve without compensation, but shall be reimbursed for all reasonable expenses incurred in the performance of their duties.
(e) Prior to submitting any application, proposal, planning document or other request seeking federal grants, matching funds or other federal support for health information technology or health information exchange, the Health Information Technology Officer or the Commissioner of Social Services shall present such application, proposal, document or other request to the council for review and comment.
Sec.
21.
Sections 17b-354b and 17b-354c of the general statutes are repealed.
18 October 1, 2017 19a-654(c) Sec.
18 July 1, 2017 19a-654(c) Sec.
19 October 1, 2017 19a-486b(b) Sec.
19 July 1, 2017 19a-486b(b) Sec.
20 July 1, 2017 Repealer section Statement of Purpose:
20 July 1, 2017 17b-59f Sec.
To implement the Governor's budget recommendations.
21 July 1, 2017 Repealer section Statement of Legislative Commissioners:
[Proposed deletions are enclosed in brackets.
In Section 7(e), the phrase "Except as provided in this subsection, the" was bracketed and "The" was added for accuracy.
Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]
PH Joint Favorable Subst.
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Action History

  1. FILE NO. 574

  2. SENATE CALENDAR NUMBER 333

  3. FAV. RPT., TAB. FOR CAL., SEN.

  4. RPTD. OUT OF LCO

  5. REFERRED TO Office of Legislative Research AND Office of Fiscal Analysis 04/12/17

  6. FILED WITH LCO

  7. Joint Favorable Substitute

  8. PUBLIC HEARING 0320

  9. REF. TO JOINT COMM. ON Public Health

Sponsors

  • Martin M.' b'Looney · Primary
  • Joe' b'Aresimowicz · Primary
  • Matthew' b'Ritter · Primary
  • Bob' b'Duff · Primary

Sponsorship breakdown

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4 sponsors · 0 co-sponsors · 183 not signed on

Sponsors (4)

  • b'Looney, Martin M.'
  • b'Aresimowicz, Joe'
  • b'Ritter, Matthew'
  • b'Duff, Bob'

Co-sponsors (0)

None.

Not signed on (183)

183 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

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Subjects

healthcare
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Frequently asked questions

Who sponsors SB 795?
SB 795 is sponsored by b'Looney, Martin M.', b'Aresimowicz, Joe', b'Ritter, Matthew', and b'Duff, Bob'.
What is the current status of SB 795?
This bill died with 2017 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
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