SB 9 — AN ACT PROMOTING HOSPITAL FINANCIAL STABILITY.

or (iii) HUSKY Health, as defined in section 17b-290, and (B) if the mental health facility does not accept or stops accepting reimbursement for any covered benefit provided to a covered individualsSB9 under/ aFile policy,No. plan or program described in clause (i), (ii) or (iii)ofsubparagraph(A)ofthissubdivision,acertificateofneedforsuch increase in the licensed bed capacity shall be required.

(24)381 The10 establishmentsSB9 atFile harmNo. reduction centers through the pilot program established pursuant to section 17a-673c;

381 individual under a policy, plan or program described in clause (i), (ii) or (iii)ofsubparagraph(A)ofthissubdivision,acertificateofneedforsuch increase in the licensed bed capacity shall be required;

[.] (24) The establishment at harm reduction centers through the pilot program established pursuant to section 17a-673c;

(d) The executive director of the Office of Health Strategy may implement policies and procedures necessary to administer the provisions of this section while in the process of adopting such policies and procedures as regulation, provided the executive director holds a public hearing prior to implementing the policies and procedures and posts notice of intent to adopt regulations on the office's Internet web site and the eRegulations System not later than twenty days after the LCOdate No.ofimplementation.Policies andproceduresimplementedpursuant to this section shall be valid until the time final regulations are adopted.

654(e) 11On ofor 20before Governor'sJune Bill30, No.92026, datea ofimplementation.Policiesmental andproceduresimplementedpursuanthealth facility seeking to increase licensed bed capacity without applying for a certificate of need, as permitted pursuant to subdivision (23) of subsection (b) of this sectionsection, shall benotify validthe untilOffice theof timeHealth finalStrategy, regulationsin area adopted.form and manner sSB9 / File No.

(e)381 On11 orsSB9 beforeFile JuneNo. 30, 2026, a mental health facility seeking to increase licensed bed capacity without applying for a certificate of need, as permitted pursuant to subdivision (23) of subsection (b) of this section, shall notify the Office of Health Strategy, in a form and manner prescribed by the executive director of said office, regarding (1) such facility's intent to increase licensed bed capacity, (2) the address of such facility, and (3) a description of all services that are being or will be provided at such facility.

(f)381 Notwithstandingprescribed by the provisionsexecutive director of thissaid sectionoffice, andregarding sections(1) 19a-such 639,facility's asintent amendedto byincrease thislicensed act,bed andcapacity, 19a-639a,(2) on or before December 31, 2025, the unitaddress shall automatically issue a certificate of needsuch to any large grouppracticeor healthcare facility, exceptand ahospitallicensedpursuant(3) to chapter 368v, for a transferdescription of ownership,all asservices definedthat inare subparagraphbeing (C)or ofwill subdivisionbe (16)provided ofat section 19a-630, as amended by this act, upon such practicefacility. or facility's submission of a certificate of need request for determination to the unit.

(f) Notwithstanding the provisions of this section and sections 19a- 639, as amended by this act, and 19a-639a, on or before December 31, 2025, the unit shall automatically issue a certificate of need to any large grouppracticeor healthcare facility,except ahospitallicensedpursuant to chapter 368v, for a transfer of ownership, as defined in subparagraph (C) of subdivision (16) of section 19a-630, as amended by this act, upon such practice or facility's submission of a certificate of need request for determination to the unit.

LCO(1) No.Whether the proposed project is consistent with any applicable policies and standards adopted in regulations by the Office of Health Strategy;

654 12 of 20 Governor's Bill No.9 (1) Whether the proposed project is consistent with any applicable policies and standards adopted in regulations by the Office of Health Strategy;

(3)sSB9 Whether/ [thereFile isNo. a clear] the applicant has satisfactorily demonstrated that theproposed project is consistent with a public need, [for the health care facility or services proposed by the applicant] including, but not limited to, a public health or community health need identified in a community health needs assessment, community service plan, community health improvement plan, community profile, the applicant's long-term plan or other similar report characterizing the health needs of the community;

381 12 sSB9 File No.

381 (3) Whether [there is a clear] the applicant has satisfactorily demonstrated that theproposed project is consistent with a public need, [for the health care facility or services proposed by the applicant] including, but not limited to, a public health or community health need identified in a community health needs assessment, community service plan, community health improvement plan, community profile, the applicant's long-term plan or other similar report characterizing the health needs of the community;

LCO[(6) No.The] (8) Whether the applicant has satisfactorily demonstrated that the proposal will not negatively affect the applicant's [past and proposed] provision of health care services to relevant patient populations [and] or alter the applicant's payer mix, including, but not limited to, [access to] a decrease in the provision of services [by] to Medicaid and Medicare recipients and indigent persons;

654[(7) 13 of 20 Governor's Bill No9 [(6) The] (8) Whether the applicant has satisfactorily demonstratedidentified that the proposalpopulation willsSB9 not/ negativelyFile affectNo. the applicant's [past and proposed] provision of health care services to relevant patient populations [and] or alter the applicant's payer mix, including, but not limited to, [access to] a decrease in the provision of services [by] to Medicaid and Medicare recipients and indigent persons;

[(7)381 Whether13 thesSB9 applicantFile hasNo. satisfactorily identified the population to be served by the proposed project and satisfactorily demonstrated that the identified population has a need for the proposed services;

381 to be served by the proposed project and satisfactorily demonstrated that the identified population has a need for the proposed services;

and (14) Whether the applicant has satisfactorily demonstrated that the proposal will not negatively impact the finances of the health care LCOfacility No.so as to jeopardize or substantially impair the facility's future operations.

654(b) 14In deliberations as described in subsection (a) of 20this Governor'ssection, Billthere 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 (3) of subsection (a) of section 19a-638, as amended by this act, when an offer was made in response to a request sSB9 / File No.

9381 facility14 sosSB9 asFile toNo. jeopardize or substantially impair the facility's future operations.

(b)381 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 (3) 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.

LCO(D) No."Purchaser" means a person who is acquiring, or has acquired, any assets of a hospital through a transfer of ownership of a hospital;

654 15 of 20 Governor's Bill No.9 (D) "Purchaser" means a person who is acquiring, or has acquired, any assets of a hospital through a transfer of ownership of a hospital;

(F) "Transfer" means to sell, transfer, lease, exchange, option, convey, give or otherwise dispose of or transfer control over, including, but not limited to, transfer by way of merger or joint venture not in the ordinary coursesSB9 of/ business;File No.

381 15 sSB9 File No.

381 course of business;

LCO(3) No.The unit shall deny any certificate of need application involving a transfer of ownership of a hospital unless the executive director 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.

654(4) 16 of 20 Governor's Bill No9 (3) The unit shallmay deny any certificate of need application involving a transfer of ownership of a hospital unlesssubject the executive director finds that the affected community will be assured of continued access to higha qualitycost and affordablemarket healthimpact caresSB9 after/ accountingFile forNo. any proposed change impacting hospital staffing.

(4)381 The16 unitsSB9 mayFile denyNo. 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, if the executive director finds that (A) 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) any likely increases in the prices for health care services or total health care spending inthestate maynegatively impact theaffordability of care.

381 review pursuant to section 19a-639f, if the executive director finds that (A) 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) any likely increases in the prices for health care services or total health care spending inthestate maynegatively impact theaffordability of care.

(6) In any deliberations involving a certificate of need application filed pursuant to section 19a-638, as amended by this act, that involves the transfer of ownership of a hospital and that is subject to a cost and market impact review, the unit shall be permitted to consider the preliminary report, response to the preliminary report, final report and LCOany No.written comments from the parties regarding the reports issued or submitted as part of the review, provided the unit has determined that the disclosure of any such reports is appropriate in light of the considerations set forth in subsection (c) of section 19a-639f and each party in the certificate of need proceeding was provided an opportunity ofnot lessthanfourteendaysafterthedateofissuance ofthefinalreport to provide written comments on the reports issued as part of the review process.

654sSB9 17/ ofFile 20No. Governor's Bill No9 any written comments from the parties regarding the reports issued or submitted as part of the review, provided the unit has determined that the disclosure of any such reports is appropriate in light of the considerations set forth in subsection (c) of section 19a-639f and each party in the certificate of need proceeding was provided an opportunity ofnot lessthanfourteendaysafterthedateofissuance ofthefinalreport to provide written comments on the reports issued as part of the review process.

(e)381 (1)17 IfsSB9 theFile certificateNo. 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 hadnet patient revenue forfiscalyear2013inanamount greaterthanonebillion 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 forfiscalyear2013inanamount greaterthanonebillion fivehundredmilliondollars,or anypersonthatisorganizedoroperated for profit, and (C) such application is approved, the unit shall hire an independent consultant to serve as a post-transfer compliance reporter for a period of not less than three years after completion of the transfer of ownership of the hospital.

381 (e) (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 hadnet patient revenue forfiscalyear2013inanamount greaterthanonebillion 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 forfiscalyear2013inanamount greaterthanonebillion fivehundredmilliondollars,oranypersonthatisorganizedoroperated for profit, and (C) such application is approved, the unit shall hire an independent consultant to serve as a post-transfer compliance reporter for a period of not less than three years after completion of the transfer of ownership of the hospital.

(2) If the reporter finds that the purchaser has breached a condition LCOof No.the approval of the certificate of need application, the unit may, in consultation with the purchaser, the reporter and any other interested parties it deems appropriate, implement a performance improvement plan designed to remedy the conditions identified by the reporter and continue the [reporting] compliance monitoring period for up to one year following a determination by the unit that [such] all conditions have been [resolved] satisfied.

654(3) 18The ofpurchaser 20shall Governor'sprovide Billfunds, No9 of the approval of the certificate of need application, the unit may, in consultationan withamount thedetermined purchaser, the reporter and any other interested parties it deems appropriate, implement a performance improvement plan designed to remedy the conditions identified by thesSB9 reporter/ andFile continueNo. the [reporting] compliance monitoring period for up to one year following a determination by the unit that [such] all conditions have been [resolved] met.

(3)381 The18 purchasersSB9 shallFile provideNo. funds, in an amount determined by the unit not to exceed two hundred thousand dollars annually, for the hiring of the post-transfer compliance reporter.

381 the unit not to exceed two hundred thousand dollars annually, for the hiring of the post-transfer compliance reporter.

(NEW) (Effective July 1, 2024) (a) On or before October 31, 2024, and quarterly thereafter, each hospital, as defined in section 12-263p of the general statutes, shall submit a report to the executive director of the Office of Health Strategy that identifiesidentifies, for the prior calendar quarter, (1) any vendor invoices that remained unpaid for more than ninety days after receipt, regardless of whether the hospital disputes such invoice, at(2) the endoutstanding ofbalances theon priorsuch calendarinvoices, quarter,(3) (2) the outstandingnumber balancesof days of cash on suchhand, invoices(4) atthe operating margin, (5) the endofthepriortotal calendarmargin, quarter,(3)the(6) numberunpaid ofdaysofcashonhandrent, at(7) theunpaid endutilities, of(8) thefees, priortaxes calendaror quarter,assessments (4)owed theto operatingpublic marginutilities, forand the(9) priorunpaid calendaremployee quarter,health andinsurance (5)premiums, theincluding totalunpaid margincontributions, forclaims theor priorother calendarobligations quarter.supporting employees under a self-funded insurance plan.

A hospital may request an extensionextensionofnot more thanfifteendays to comply withtherequirements of notthis moresubsection thanin fifteendaystoa complywiththerequirementsofthissubsectioninaformform and manner prescribed by the executive director.

The executive director may grant such request for good cause, as determined by the executive LCOdirector. No.

654 19 of 20 Governor's Bill No.

9 director.

Prior to imposing any penalty pursuant to this subsection, the executive director shall notify the hospital of the alleged violation and the accompanying penalty and shall permit such hospital to request that the office review itssSB9 findings./ File No.

381 19 sSB9 File No.

381 its findings.

3 from passage 19a-630 October 1, 2024 Sec.

4 October 1, 2024 19a-638 Sec.

6 July 1, 2024 New section Statement of Purpose:Legislative Commissioners:

ToIn implementSection the5(e)(2), Governor's"met" budgetwas recommendations.changed to "satisfied" for clarity.

[ProposedPH deletionsJoint areFavorable enclosedSubst. in brackets.

ProposedsSB9 additions/ areFile 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.] LCO No.

654381 20 ofsSB9 20File No.

381 The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose.

In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.

Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note State Impact:

Agency Affected Fund-Effect FY 25 $ FY 26 $ Office of Health Strategy GF - Cost 96,000 96,000 State Comptroller - Fringe GF - Cost 39,600 39,600 Benefits1 Resources of the General Fund GF - Revenue See Below See Below Gain Note:

GF=General Fund Municipal Impact:

None Explanation Section 1 of the bill authorizes the Department of Public Health (DPH),starting7/1/24,toimposeacivilpenaltyofupto$25,000against a health care institution for noncompliance with statutory or regulatory requirements, which results in a potential minimal revenue gain to the resources of the General Fund (GF).

Section2 resultsin a potentialminimalGF revenue gainasit requires DPH to establish hospital Emergency Department (ED) diversion requirements and allows, as of 7/1/24, it to assess a civil penalty not to exceed $25,000 on any hospital that violates these requirements.

Section 3 results in a potential revenue gain to the General Fund by 1The fringe benefit costs for most state employees are budgeted centrally in accounts administered by the Comptroller.

The estimated active employee fringe benefit cost associated with most personnel changes is 41.25% of payroll in FY 25.

For example, when hospitals reroute incoming ambulances to other hospitals because their ED resources are fully committed, or they lack necessary medical expertise.

sSB9 / File No.

381 21 sSB9 File No.

381 expanding the Office of Health Strategy’s (OHS') Health Systems Planning Unit (HSPU's) Certificate of Need (CON) requirements.

The revenue gain is dependent on the number of applications received and the cost of the transfer associated with the application .

Section 4 modifies the CON program for health care entities beginning in FY 25, increasing annual HSPU expenditures by $135,600 annually to support an Associate Health Care Analyst's salary and associated fringe benefits.

Costs related to HSPU are recovered via an assessment collected from the various state hospitals;

this assessment results in a revenue gain to the General Fund that will offset the increased cost to OHS.

The Out Years The annualized ongoing fiscal impact identified above would continue into the future subject to inflation, the number of applications received, and the costs of the transfers associated with the applications..

The application fee is determined by the cost of the project, based on a scale described in subsection (a) of Sec.

19a-639a of the CT General Statutes.

sSB9 / File No.

381 22 sSB9 File No.

381 OLR Bill Analysis sSB 9 AN ACT PROMOTING HOSPITAL FINANCIAL STABILITY.

SUMMARY This bill modifies the state’s Certificate of Need (CON) program for health care entities, administered by the Office of Health Strategy’s (OHS) Health Systems Planning Unit (HSPU).

Under the program, health care entities must generally receive CON approval when establishing new facilities or services, changing ownership, acquiring certain equipment, or terminating certain services.

The bill adds to the types of transactions that require CON approval:

(1) transfers of a controlling interest in any entity with at least a 20% interest of a health care facility, institution, or large group practice (i.e., eight or more full-time equivalent physicians);

(2) transfers of at least 10% of a hospital’s assets;

and (3) issuance of dividends over any three- year period that exceed 20% of a hospital’s net worth.

Among other changes to CON transactions, the bill (1) eliminates current law’s CON requirement for acquiring computed tomography (CT) scanners and (2) requires HSPU to automatically issue a CON for non-hospital ownership transfers, temporarily until December 31, 2025.

The bill also modifies the criteria HSPU must use when reviewing CON applications to, among other things, include whether the (1) applicant’s actions or inactions contributed to the conditions that resulted ina requesttoterminate servicesand(2)applicant satisfactorily showed the proposal will not affect its finances in a way that would impair its future operations.

Additionally, the bill makes the following changes affecting health sSB9 / File No.

381 23 sSB9 File No.

381 care facility oversight:

1.

authorizes the Department of Public Health (DPH) to impose a civil penalty of up to $25,000 against a health care institution for noncompliance with statutory or regulatory requirements, in addition to various other disciplinary actions authorized under existing law (e.g., license suspension or revocation, probation, or a letter of reprimand) (§ 1);

2.

requires DPH to establish emergency department diversion requirements for hospitals when they reroute incoming ambulances to other hospitals and subjects hospitals and emergency medical services (EMS) organizations to disciplinary action for noncompliance with the requirements (§ 2);

3.

requires hospitals to report quarterly to OHS, starting by October 31, 2024, on specified financial information (e.g., invoices unpaid for more than 90 days and their balances) and subjects them to a civil penalty of up to $10,000 for each incident of noncompliance (§ 6);

and 4.

requires OHS to report quarterly, starting by November 30, 2024, to the Office of Policy and Management secretary summaries of the reports it receives from hospitals for the prior calendar quarter (§ 6).

Lastly, the bill makes minor, technical, and conforming changes.

EFFECTIVE DATE:

July 1, 2024, except that the provisions (1) modifying CON program requirements take effect October 1, 2024, and (2) changing CON definitions take effect upon passage.

§ 1 — DPH DISCIPLINARY AUTHORITY FOR HEALTH CARE INSTITUTIONS The bill authorizes the DPH commissioner, after a hearing held in accordance with the Uniform Administrative Procedure Act, to impose a civil penalty of up to $25,000 on a health care institution (e.g., a hospital, freestanding emergency department, outpatient surgical sSB9 / File No.

381 24 sSB9 File No.

381 facility, or long-term care facility) when she finds that the institution substantially failed to comply with statutory or regulatory requirements, including licensing regulations.

Existing law already authorizes the commissioner to take various other disciplinary actions for these reasons, such as license suspension, revocation, or censure;

probation;

a corrective action plan;

or a letter of reprimand.

§ 2 — HOSPITAL EMERGENCY DEPARTMENT DIVERSIONS The bill requires DPH to establish emergency department diversion requirements for hospitals when they reroute incoming ambulances to other hospitals because (1) their emergency department’s resources are fully committed and unavailable to incoming ambulance patients (i.e., “saturation”) or (2) they lack medical capability.

Specifically, DPH must establish the following:

1.

hospital emergency department diversion requirements that include, at a minimum, each hospital to adopt related policies and their required content;

2.

the permissible grounds for which a hospital may declare an emergency department diversion and procedures it must follow after doing so;

3.

requirements for hospitals receiving diverted patients (i.e., “receiving hospitals”);

and 4.

requirements for licensed or certified EMS organizations when a hospital declares an emergency department diversion.

Before declaring an emergency department diversion, the bill requires a hospital to notify DPH as the commissioner prescribes.

It also subjects violators to (1) a civil penalty of up to $25,000 for hospitals and (2) various DPH disciplinary actions (e.g., license suspension, revocation, or censure) for EMS organizations.

sSB9 / File No.

381 25 sSB9 File No.

381 Under the bill, the DPH commissioner must adopt regulations to implement the emergency department diversion requirements and may implement policies and procedures while doing so if she publishes her intent to adopt regulations on the eRegulations system within 20 days after implementing the policies and procedures.

The policies and procedures are valid until the final regulations are adopted.

§§ 3-5 — CERTIFICATE OF NEED Definition of “Person” The bill adds public companies and entities (e.g., nonprofits, business trusts, and estates) to the statutory definition of “person” for purposes of the CON program.

Under current law, “person” also includes any individual, partnership, corporation, limited liability company, association, government subdivision, agency, or private organization of any character.

By law, HSPU may impose civil penalties on a “person” that fails to file required data or information, as it may do for health care facilities and large group practices.

Transactions Requiring CON Approval By law, health care institutions must generally receive approval from HSPU when establishing new facilities or services, changing ownership, acquiring certain equipment, or terminating services.

The bill adds to the types of transactions that require CON approval the following:

1.

transfers of a controlling interest in any entity (e.g., corporation, nonprofit, limited liability company, or partnership) that directly or indirectly controls or possesses at least 20% interest of a health care facility, institution, or large group practice, instead of only ownership transfers that impact the facility, institution, or practice itself;

2.

transfersofatleast 10%ofahospital’sassets,including real estate transfers;

and sSB9 / File No.

381 26 sSB9 File No.

381 3.

the issuing of dividends over any three-year period that exceed 20% of a hospital’s net worth.

Temporary Automatic CON Approvals for Non-Hospital Ownership Transfers The bill requires HSPU to automatically issue a CON for ownership transfers for large group practices and health care facilities other than hospitals that submit a CON determination request (i.e., non-hospital ownership transfers).

HSPU must do this until December 31, 2025, regardless of existing CON laws.

CON Exemptions for CT Scanners The bill eliminates the CON requirement for acquiring CT scanners.

Current law requires a CON when acquiring MRI, CT, PET, and PET/CT scanners, unless they are replacements for scanners previously approved through the CON process.

CON Review Criteria The bill adds to the factors HSPU must consider when reviewing a CON application the following:

1.

for service terminations, whether and to what extent the applicant’s actions or inactions caused or contributed to the conditions that result in filing the application;

and 2.

whether the applicant satisfactorily demonstrated that the proposal will not negatively impact the health care facility’s finances in a way that jeopardizes or substantially impairs its future operations.

Under current law, the unit must consider whether there is a clear public need for the applicant’s proposal.

The bill specifies that this includes a public health or community health need identified in a community health needs assessment, community service plan, community health improvement plan, community profile, the applicant’s long-term plan, or other similar report.

sSB9 / File No.

381 27 sSB9 File No.

381 Current law also requires the unit to consider several other criteria related to health care quality, access, cost effectiveness, and financial feasibility.

The bill makes minor changes to these criteria, principally by separating these different components into distinct criteria.

By law, HSPU may revise the review criteria by regulation.

The bill allowstheOHSexecutivedirectortoimplementpoliciesandprocedures to update the criteria while in the process of adopting them in regulations.

Before implementing the policies and procedures, the bill requires her to (1) hold a public hearing at least 30 days before and (2) publish her intent to adopt regulations on the OHS website and eRegulations system within 20 days after implementing them.

The policies and procedures are valid untilthe final regulations are adopted.

Cost and Market Impact Reviews By law, HSPU must conduct a cost and market impact review(CMIR) of CON applications that propose to transfer a hospital’s ownership if the purchaser is (1) an in- or out-of-state hospital or hospital system that had net patient revenue exceeding $1.5 billion for fiscal year 2013 or (2) organized or operated for profit (CGS § 19a-639f).

The bill expressly authorizes HSPU, when reviewing these CON applications, to consider the CMIR preliminary report and the response to it, the final report, and the parties’ written comments on reports that are part of the review.

HSPU may do this if it determined disclosing the reports is appropriate and each party in the CON proceeding was given at least 14 days after the final CMIR report was issued to submit written comments on these reports.

Additionally, when the HSPU approves a CON for these hospital ownership transfers, current law requires the unit to hire an independent consultant to serve as a post-transfer compliance reporter for three yearsfollowing thetransfer’scompletion.The billspecifiesthat three years is the minimum time period the reporter must serve.

§ 6 — HOSPITAL FINANCIAL REPORTING TO OHS The bill requires hospitals to report quarterly, starting by October 31, sSB9 / File No.

381 28 sSB9 File No.

381 2024, to the OHS executive director on the following information for the prior calendar quarter:

1.

any vendor invoices unpaid for more than 90 days after their receipt, regardless of whether the hospital disputed them, and their outstanding balances;

2.

the number of days of cash on hand;

3.

the operating and total margins;

4.

unpaid rent or utilities;

5.

fees, taxes, or assessments owed to public utilities;

and 6.

unpaid employee health insurance premiums, including unpaid contributions, claims, or other obligations supporting employees under self-insured plans.

The bill requires the executive director to develop a uniformtemplate for hospitals to use to submit the quarterly reports to OHS and to post the template on the OHS website.

The template must (1) include definitions for the terms it uses and (2) allow for hospitals to explain disputed charges.

Under the bill, hospitals may request an extension of up to 15 days to comply with the reporting requirement, as the executive director prescribes.

She may grant an extension request for good cause.

Hospitals who violate the bill’s reporting requirements are subject to a civil penalty of up to $10,000 for each incident of noncompliance.

Before imposing a penalty, the bill requires the executive director to notify the hospital of the alleged violation and associated penalty and allowthehospitaltorequest OHStoreviewitsfindings.A hospitalmust request the review within 15 days after receiving the notice and the executive director cannot impose the penalty until the review is completed.

Any penalties OHS collects must be deposited into the General Fund.

sSB9 / File No.

381 29 sSB9 File No.

381 The bill also requires OHS to report quarterly, starting by November 30, 2024, to the Office of Policy and Management secretary summaries of the reports it receives from hospitals for the prior calendar quarter.

BACKGROUND Related Bills SB 440, favorably reported by the Public Health Committee, makes various changes to the CON program, such as modifying the types of transactions that require, and are exempt from, CON approval;

transferring responsibility, from HSPU to the attorney general, for conducting cost and market impact reviews of certain hospital ownership transfers;

and shortening the deadlines for certain CON processes.

HB 5316, favorably reported by the Public Health Committee, makes various changes to CON program requirements for large group practices.

COMMITTEE ACTION Public Health Committee Joint Favorable Substitute Yea 24 Nay 12 (03/22/2024) sSB9 / File No.

381 30