DPH: OHCA- Public&Special Acts

Public & Special Acts

OHCA's designated roles and responsibilities may be changed, augmented or diminished by periodic legislative acts by the General Assembly.

What is a public act? 
A bill passed by both chambers of the legislature that amends the general Statutes

What is a special act?
A law that has a limited application or is of limited duration, not incorporated into the Connecticut General Statutes.

2014 Public Acts regarding the Office of Health Care Access

Public Act 14-168
An Act concerning Notice of Acquisitions, Joint Ventures, Affiliations of Group Medical Practices and Hospital Admissions, Medical Foundations and Certificates of Need.

Section 1
Section 1 of Public Act 14-168 has an effective date of October 1, 2014 and mandates that hospitals and hospital systems provide certain filings to OHCA not later than December 31, 2014, and annually thereafter.  Specifically, Subsection (f) requires each hospital and hospital system to file a written report describing the activities of group practices owned or affiliated with the hospital or hospital system.  Additionally, subsection (g) requires each group practice comprised of thirty or more physicians, that is not the subject of a report filed under subsection (f), to file a written report with OHCA not later than December 31, 2014, and annually thereafter, which identifies the physicians, specialties, services and service areas of the group practice. 

Section 3
Section 3 of Public Act 14-168 is effective upon passage.
Subsection (a)(1) provides that no person or entity that is not a member of a medical foundation shall be authorized to appoint or elect board members to the medical foundation.
Subsection (a)(2) prohibits employees or representatives of for-profit hospitals, health systems, medical schools, or entities owning or controlling the same, from serving on the board of directors of a medical foundation organized by a nonprofit hospital, health system or medical school. Conversely, this subsection also prohibits employees or representatives of nonprofit hospitals, health systems, medical schools, or entities owning or controlling the same, from serving on the board of directors of a medical foundation organized by a for-profit hospital, health system or medical school. Additionally, this subsection prohibits a person from simultaneously serving on the board of directors of a medical foundation organized by a for-profit hospital, health system or medical school and a medical foundation organized by a nonprofit hospital, health system or medical school.
Subsection (d) has been amended to require OHCA to make medical foundation filings available to members of the public and accessible on OHCA’s website.
Subsection (f) prohibits a hospital, health system or medical school from organizing or being a member of more than one medical foundation.

Section 5
Section 5 of Public Act 14-168 has an effective date of July 1, 2014 and defines the terms “group practice” and “Physician” as used in Chapter 368z of the Connecticut General Statutes. Additionally, this section adds “group practice” to the definition of a “transfer of ownership”.

Section 6
Section 6 of Public Act 14-168 has an effective date of July 1, 2014 and adds a requirement for certificate of need approval for the transfer of ownership of a group practice to an entity other than a physician or group of physicians.  This requirement is waived for parties that have signed a sale agreement to transfer such ownership on or before September 1, 2014.

Section 7
Section 7 of Public Act 14-168 has an effective date of July 1, 2014 and requires OHCA to consider whether a certificate of need applicant has satisfactorily demonstrated that its proposal will not negatively impact the diversity of health care providers and patient choice in the geographic region of the proposal and whether the applicant has satisfactorily demonstrated that any consolidation resulting from its proposal will not adversely affect health care costs or accessibility to care.
This section also provides a presumption in favor of approving a certificate of need application for the transfer of ownership of a group practice when an offer was made in response to a request for proposal or similar voluntary offer for sale.

Section 8
Section 8 of Public Act 14-168 has an effective date of July 1, 2014 and provides a sixty day review period for certificate of need applications that involve a transfer of ownership of a group practice when an offer was made in response to a request for proposal or similar voluntary offer for sale.


Section 9
Section 9 of Public Act 14-168 is effective upon passage and requires the purchaser of a nonprofit hospital and the nonprofit hospital to hold a hearing in the municipality in which the new hospital is proposed to be located.  The hearing is required to be held not later than thirty days after receipt of the certificate of need determination letter by OHCA and the Attorney General. This section also requires the purchaser and nonprofit hospital to record and transcribe the hearing and make copies available to OHCA, the Attorney General or the public upon request.

Section 10
Section 10 of Public Act 14-168 is effective upon passage and authorizes OHCA and the Attorney General to place any conditions on the approval of an application related to the purposes of sections 19a-486a to 19a-486h of the Connecticut General Statutes.

Section 11
Section 11 of Public Act 14-168 is effective upon passage and mandates that OHCA deny an application filed pursuant to subsection (d) of section 19a-486a of the Connecticut General Statutes unless OHCA 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.

2013 Public Acts regarding the Office of Health Care Access

Public Act 13-234
An Act Implementing the Governor's Budget Recommendations for Housing, Human Services and Public Health.

Section 144 modifies the criteria to be considered by OHCA when reviewing Certificate of Need applications.   Specifically, subsection (a) of 19a-639, subdivision (5) was amended to include a review of the provision of or any change in the access to services for Medicaid recipients and indigent persons and the impact upon the cost-effectiveness of providing access to services provided under the Medicaid program. Additionally, subdivision (6) was amended to include a review of the access to services by Medicaid recipients and indigent persons. 
Section 144 also adds subdivision (10) to subsection (a) of 19a-639 requiring OHCA to consider whether a Certificate of Need applicant, who has failed to provide or reduced access to services by Medicaid recipients or indigent persons, has demonstrated good cause for doing so, which shall not be demonstrated solely on the basis of differences in reimbursement rates between Medicaid and other health care payers.
Section 147 requires each nonprofit hospital to submit to OHCA: (1) a complete copy of such hospital's most-recently completed Internal Revenue Service form 990, including all parts and schedules; and (2) data compiled to prepare such hospital's community health needs assessment, which shall not include: (A) Individual patient information, including, but not limited to, patient-identifiable information; (B) information that is not owned or controlled by such hospital; (C) information that such hospital is contractually required to keep confidential or that is prohibited from disclosure by a data use agreement; or (D) information concerning research on human subjects.
Section 148 deleted the exception from civil penalties for health care facilities or providers that fail to complete the inventory questionnaire, as required by section 19a-634.  Therefore, those health care facilities or providers that fail to complete the inventory questionnaire are subject to a civil penalty.
Section 149 defines a "Detailed patient bill" as a patient billing statement that includes, in each line item, the hospital's current pricemaster code, a description of the charge and the billed amount; and (2) "pricemaster" means a detailed schedule of hospital charges.
This Act is effective as of October 1, 2013.

Public Act 13-208
An Act Concerning Various Revisions to the Public Health Statutes.

Section 69 is effective from passage and requires each hospital, as defined in section 19a-631 of the general statutes, that has obtained a certificate of need from the Office of Health Care Access that permits such hospital to provide coronary angioplasty services in an emergency situation but does not permit such services on an elective basis, to report, from October 1, 2013, to September 30, 2014, inclusive, to the Department of Public Health once each month: (1) The number of persons upon whom the hospital performed an emergency coronary angioplasty and who were discharged to another hospital in order to receive an elective coronary angioplasty; and (2) the number of persons upon whom the hospital performed an emergency coronary angioplasty and who were discharged by such hospital to another hospital in order to receive open-heart surgery.

 

2012 Public Acts regarding the Office of Health Care Access

Public Act 12-170

An Act Concerning The OFFICE OF HEALTH CARE ACCESS

This Act is effective from passage and allows OHCA to consider financial feasibility as an alternative to the impact on the financial strength of the health care system in the state when evaluating Certificate of Need applications.  It further sets forth a filing date of March 31st of each year for the submission of acute care and children's hospitals' verification of net revenue and eliminates various obsolete references within the hospital financial filing statutes.  The Act changes the utilization study from annual to biennial and requires the statewide health care facilities and services plan to be released every two years, rather than five.  The Act allows OHCA to release patient identifiable data to 1) a state agency if for health care service delivery improvement; 2) a federal agency or the Attorney General if investigating hospital mergers or acquisitions; or 3) another state's health data collection agency if engaging in a reciprocal data sharing arrangement, provided patient confidentiality is protected.

 

2011 Public Acts regarding the Office of Health Care Access

Public Act 11-10

An Act Concerning Exemptions from the Certificate of Need Process for Researchers Utilizing Certain Technologies that Have no Impact on Human Health

This act is effective from passage and provides that a Certificate of Need is not required for the acquisition by any person for any equipment that is to be used exclusively  for scientific research that is not conducted on humans.

Public Act 11-44

An Act Concerning the Bureau of Rehabilitative Services and Implementation of Provisions of the Budget Concerning Human Services and Public Health

Sections 174 through 178 of the Act are effective July 1, 2011 and make significant changes to statutes pertaining to the collection of financial data from hospitals. 

Section 174 changes the language of General Statutes § 19a-649 by removing the language requiring consultation with Commissioner of Social Services and removing the requirement that hospitals obtain an independent audit of the level of charges, payments and discharges by primary payer related to Medicare, medical assistance, CHAMPUS or Tricare and nongovernmental payers as well of the amount of uncompensated care including emergency assistance to family. Each hospital is still required to file an audited financial statement by February 28 of each year and the filing must include a verification of the hospital's net revenue for the most recently completed fiscal year.

Section 175 repeals the "Base year" definitions and removes the reference to the SAGA program in the definition of "Medical Assistance," removes the reference to the uncompensated care program disproportionate share hospital payments from the definition of "net revenue," and repeals the definition of "emergency assistance to families" in General Statutes § 19a-659.

Section 176 removes all references to the disproportionate share program and changes the date on which the Office is required to report the results of the office's review of the hospitals' annual and twelve month filings under sections 19a-644, 19a-649 and 19a-676 from June 1 to September 1.

Section 177 removes references to repealed sections of OHCA's statutes in section 19a-493b.

Section 178 repeals General Statutes §§ 19a-662, 19a-670a, 19a-671a, 19a-672, 19a-672a and 19a-683.

Public Act 11-61

An Act Implementing the Revenue Items in the Budget, Making Budget Adjustments, Deficiency Appropriations, Certain Revisions to the Bills of the Current Session and Miscellaneous Changes to the General Statutes

Section 143 is effective July 1, 2011 and makes changes to section 19a-654 with respect to the collection of data from Hospitals and Outpatient Surgical Facilities.  Each hospital is required to submit patient identifiable inpatient discharge data and emergency department data to the Office.  Outpatient surgical facilities are required to submit data required under subsection (c) of section 19a-634.  The Office is required to convene a working group to develop recommendations to address current obstacles and proposed requirements for patient-identifiable data reporting in an outpatient setting.  The group is required to report on its findings and recommendations to the legislature on or before February 1, 2012.  Additional reporting of outpatient data as deemed necessary by the Office shall begin no later than July 1, 2015. Other changes include the definitions for patient- identifiable data and de-identified patient data; sharing of data with the Comptroller; release of de-identified patient data; prohibition on release of patient-identifiable data and release of data per section 19a-25.

Public Act 11-183

An Act Requiring Certificate of Need Approval for the Termination of Inpatient and Outpatient Services by a Hospital

Section 1 changes the language subdivision (4) of subsection (a) of section 19a-638 by requiring a certificate of need for the termination of inpatient or outpatient  services by a hospital, including but not limited to, the termination of inpatient and outpatient mental health and substance abuse services.  A new subdivision requiring a CON for the termination of services by an outpatient surgical facility, as defined in section 19a-493b, or a facility that provides outpatient surgical services as part of the outpatient surgery department of a hospital provided the termination of services due to insufficient volume or the termination of any subspecialty service shall not require CON approval.

In subsection (b) of 19a-638, subdivision (20) was repealed and the other sections were renumbered accordingly. 

Section 2 of the Act changes section 19a-639e to refer to subsection (a) of 19a-638 and the new requirement regarding termination of services.

Section 3 of the Act changes the language of subdivision of (c) of section 19a-634 to reference the appropriate subdivisions of 19a-638. 

This Act is effective from passage.

Public Act 11-242

An Act Concerning Various Revisions to Public Health Related Statutes

Section 24 limits the authority of the Deputy Commissioner of Public Health who oversees OHCA to Certificate of Need decisions and removes obsolete language with respect to the Commissioner of Health Care Access on September 1, 2009 serving as the Deputy Commissioner and the report on CON reform from 2010.

Section 25 changes the language of subsection (b) of 19a-639a to require that a CON application shall be filed with the office not later than 90 days after the applicant publishes notice.  The requirement that OHCA file a notice of receipt of a CON application with the Secretary of State has also been removed.

Section 80 requires a CON for the termination of services by a state hospital, facility or institution.

Section 86 changes the hospital assessment late fees.  Effective July 1, 2011, hospitals that do not pay their assessments when due will incur a late fee of 2% during the first five days after the due date, 5% payments made between the sixth day and fifteenth day after the due date and 10% for payments made more than 15 days beyond the due date. If a hospital fails to pay any assessment for more than thirty days after it is due, the Commissioner may impose civil penalties of up to a $1,000 per day.

Section 89 provides for the payment of hospital assessments through an electronic funds transfer.

 

2010 Public Acts regarding the Office of Health Care Access

 




Content Last Modified on 7/25/2014 1:35:41 PM