Senate Bill No. 311

(By Senator Bailey)


[Introduced February 10, 1995; referred to the Committee
on Health and Human Resources; and then to the Committee on Finance.]

A BILL to amend and reenact section three, article twenty-nine-b, chapter sixteen of the code of West Virginia, one thousand nine hundred thirty-one, as amended, relating to exemption of rural hospitals and swing beds; and limited exemption for small hospitals.

Be it enacted by the Legislature of West Virginia:
That section three, article twenty-nine-b, chapter sixteen of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be amended and reenacted to read as follows:

§16-29B-3. Definitions.

As used in this article, unless a different meaning clearly appears from the context:
(a) "Charges" means the economic value established for accounting purposes of the goods and services a hospital provides for all classes of purchasers;
(b) "Class of purchaser" means a group of potential hospital patients with common characteristics affecting the way in which their hospital care is financed. Examples of classes of purchasers are medicare beneficiaries, welfare recipients, subscribers of corporations established and operated pursuant to article twenty-four, chapter thirty-three of this code, members of health maintenance organizations and other groups as defined by the board;
(c) "Board" means the three member board of directors of the West Virginia health care cost review authority, an autonomous division within the state department of health;
(d) "Health care provider" means a person, partnership, corporation, facility or institution licensed, certified or authorized by law to provide professional health care service in this state to an individual during this individual's medical care, treatment or confinement;
(e) "Hospital" means a facility subject to licensure as such under the provisions of article five-b of this chapter and any acute care facility operated by the state government which is primarily engaged in providing to inpatients, by or under the supervision of physicians, diagnostic and therapeutic services for medical diagnosis, treatment and care of injured, disabled or sick persons, and does not include state mental health facilities or state long-term care facilities except rural primary care hospitals and swing beds that are used for long-term care and respite services which are exempt from rate review, and except hospitals having less than seventy-five acute beds and no less than fifty percent or more of the hospital's revenues is derived from governmental payors which shall be reviewed every three years;
(f) "Person" means an individual, trust, estate, partnership, committee, corporation, association or other organization such as a joint stock company, estate or political subdivision or instrumentality thereof;
(g) "Purchaser" means a consumer of patient care services, a natural person who is directly or indirectly responsible for payment for such patient care services rendered by a hospital, but does not include third-party payors;
(h) "Rates" means all value given or money payable to hospitals for health care services, including fees, charges and cost reimbursements;
(i) "Records" means accounts, books and other data related to health care costs at health care facilities subject to the provisions of this article which do not include privileged medical information, individual personal data, confidential information, the disclosure of which is prohibited by other provisions of this code and the laws enacted by the federal government, and information, the disclosure of which would be an invasion of privacy;
(j) "Third-party payor" means any natural person, person, corporation or government entity responsible for payment for patient care services rendered by hospitals; and
(k) "Related organization" means an organization, whether publicly owned, nonprofit, tax-exempt or for profit, related to a hospital through common membership, governing bodies, trustees, officers, stock ownership, family members, partners or limited partners including, but not limited to, subsidiaries, foundations, related corporations and joint ventures. For the purposes of this subsection family members shall mean brothers and sisters, whether by the whole or half blood, spouse, ancestors and lineal descendents.

NOTE: The purpose of this bill is to exempt from review rural primary care hospitals and small hospitals.

Strike-throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.