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