H. B. 2822


(By Delegates Beane, Frederick
and R.M. Thompson)
[Introduced March 12, 2001; referred to the
Committee on Government Organization then Finance.]



A BILL to repeal sections nineteen, twenty and twenty-one, article twenty-nine-b, chapter sixteen of the code of West Virginia, one thousand nine hundred thirty-one, as amended; and to amend and reenact sections two, three, five, eight and ten, article twenty-nine-b of said chapter, all relating to abolishing the West Virginia health care authority; creating in its place a health care quality standards authority; providing for composition of the new authority and meetings and management; and repealing provisions of the article relating to rate setting authority.

Be it enacted by the Legislature of West Virginia:
That sections nineteen, twenty and twenty-one, article twenty-nine-b, chapter sixteen of the code of West Virginia, one thousand nine hundred thirty-one, as amended, be repealed; and that sections two, three, five, eight and ten, article twenty-nine-b of said chapter be amended and reenacted, all to read as follows:
ARTICLE 29B. HEALTH CARE AUTHORITY.
§16-29B-2. Short title.
This article may be cited as the "West Virginia Health Care Quality and Standards Authority".
§16-29B-3. Definitions.
Definitions of words and terms defined in articles two-d and five-f of this chapter are incorporated in this section unless this section has different 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 seven-member board of directors of the West Virginia health care quality and standards authority, an autonomous division within the state department of health and human resources;
(d) "Health care provider" means a person, partnership, corporation, facility, hospital 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, remedial, or behavioral health care, treatment or confinement. For purposes of this article, "health care provider" shall not include the private office practice of one or more health care professionals licensed to practice in this state pursuant to the provisions of chapter thirty of this code.
(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;
(f) "Person" means an individual, trust, estate, partnership, committee, corporation, association or other organization such as a joint stock company, a state or political subdivision or instrumentality thereof or any legal entity recognized by the state;
(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 health care provider, but does not include third-party payers payors;
(h) "Rates" means all value given or money payable to health care providers 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 health care providers; and
(k) "Related organization" means an organization, whether publicly owned, nonprofit, tax-exempt or for profit, related to a health care provider 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 descendants.
§16-29B-5. West Virginia health care and quality standards authority; composition of the board; qualifications; terms; oath; compensation and expenses of members; vacancies; appointment of chairman, and meetings of the board.

The "West Virginia Health Care Cost Review Authority", heretofore created as an autonomous division of the department of health, is hereby continued abolished and there is hereby created in its place the "West Virginia Health Care and Quality Standards Authority" as an autonomous division of the department of health and human resources and shall be known as the "West Virginia Health Care and Quality Standards Authority", hereinafter referred to as the board. Any references in this code to the West Virginia health care cost review authority shall mean means the West Virginia health care quality and standards authority.
(a) The board shall consist of three seven members, appointed by the governor, with the advice and consent of the Senate. The board members shall be citizens and residents of this state. No more than two four of said the board members may be members of the same political party. One Two board member members shall have a background in health care finance or economics, one board member shall have previous employment experience in human services, business administration or substantially related fields and one board member shall be a consumer of health services with a demonstrated interest in health care issues must be hospital administrators, one from a rural hospital and one from an urban hospital; two members must be physicians, one from a rural practice and one from an urban practice; and three citizen members, one from each congressional district in the state.
(b) Each board member shall must, before entering upon the duties of his or her office, take and subscribe to the oath provided by section five, article IV of the constitution of the state of West Virginia, which oath shall be filed in the office of the secretary of state. The governor shall designate one of the board members to serve as chairman at the governor's will and pleasure. The chairman shall be the chief administrative officer of the board. The governor may remove any board member only for incompetency, neglect of duty, gross immorality, malfeasance in office or violation of the provisions of this article. The governor shall appoint three seven board members, one three for a term of two years, one two for a term of four years and one two for a term of six years, with all the terms beginning on the twelfth day of March, one thousand nine hundred eighty-three two thousand two. All future appointments shall be for terms of six years, except that an appointment to fill a vacancy shall be for the unexpired term only. Current members of the health care authority may continue to serve until the end of the term of their appointment.
(c) No person while in the employ of, or holding any official relation to, any hospital or health care provider subject to the provisions of this article, or who has any pecuniary interest therein, may serve as a member of the board or as an employee thereof. Nor may any such if the board member be is a candidate for or hold holds public office or be is a member of any political committee while acting as such the board member; nor may any board member or employee of said the board receive anything of value, either directly or indirectly, from any third-party payor or health care provider. Should If any of the board members become becomes a candidate for any public office or for membership on any political committee, the governor shall remove said the board member from the board and shall appoint a new board member to fill the vacancy created. No board member or former board member may accept employment with any hospital or health care provider subject to the jurisdiction of the board in violation of the West Virginia governmental ethics act, chapter six-b of this code: Provided, That such this act shall does not apply to employment accepted after termination of the board.
(d) The concurrent judgment of two four of the board members when in session as the board shall be deemed is considered the action of the board. A vacancy in the board shall does not affect the right or duty of the remaining board members to function as a board.
(e) In order to adequately compensate the chairman of the board and other members of the board for additional duties newly imposed by law and not heretofore required by law, the annual salary of the chairman of the board shall be sixty-five thousand dollars and the annual salary of the other board members shall be sixty thousand dollars. The board shall pay each member the same compensation as is paid to members of the Legislature for their interim duties as recommended by the citizens legislative compensation commission and authorized by law for each day or portion thereof engaged in the discharge of official duties and shall reimburse each member for actual and necessary expenses incurred in the discharge of official duties.
§16-29B-8. Powers generally; budget expenses of the board.
(a) In addition to the powers granted to the board elsewhere in this article, the board may:
(1) Adopt, amend and Propose the adoption, amendment and repeal necessary, for appropriate and lawful policy guidelines and legislative rules in accordance with article three, chapter twenty-nine-a of this code: Provided, That subsequent amendments and modifications to any proposed rule promulgated pursuant to this article and not exempt from the provisions of article three, chapter twenty-nine-a of this code may be implemented by emergency rule;
(2) Hold public hearings, conduct investigations and require the filing of information relating to matters affecting the quality, standards and costs of health care services subject to the provisions of this article and may subpoena witnesses, papers, records, documents and all other data in connection therewith. The board may administer oaths or affirmations in any hearing or investigation;
(3) Apply for, receive and accept gifts, payments and other funds and advances from the United States, the state or any other governmental body, agency or agencies or from any other private or public corporation or person (with the exception of hospitals subject to the provisions of this article, or associations representing them, doing business in the state of West Virginia, except in accordance with subsection (c) of this section), and enter into agreements with respect thereto, including the undertaking of studies, plans, demonstrations or projects. Any such gifts or payments that may be received or any such agreements that may be entered into shall be used or formulated only so as to pursue legitimate, lawful purposes of the board, and shall in no respect inure to the private benefit of a board member, staff member, donor or contracting party;
(4) Lease, rent, acquire, purchase, own, hold, construct, equip, maintain, operate, sell, encumber and assign rights or dispose of any property, real or personal, consistent with the objectives of the board as set forth in this article: Provided, That such the acquisition or purchase of real property or construction of facilities shall be consistent with planning by the state building commissioner and subject to the approval of the Legislature;
(5) Contract and be contracted with and execute all instruments necessary or convenient in carrying out the board's functions and duties; and
(6) Exercise, subject to limitations or restrictions herein imposed, all other powers which are reasonably necessary or essential to effect the express objectives and purposes of this article.
(b) The board shall annually prepare a budget for the next fiscal year for submission to the governor and the Legislature which shall include all sums necessary to support the activities of the board and its staff.
(c) Each hospital subject to the provisions of this article shall be assessed by the board on a pro rata basis using the gross revenues of each hospital as reported under the authority of section eighteen of this article as the measure of the hospital's obligation. The amount of such the fee shall be determined by the board except that in no case shall may the hospital's obligation exceed one tenth of one percent of its gross revenue. Such The fees shall be paid on or before the first day of July in each year and shall be paid into the state treasury and kept as a special revolving fund designated "health care cost quality and standards review fund", with the moneys in such the fund being expendable after appropriation by the Legislature for purposes consistent with this article. Any balance remaining in said the fund at the end of any fiscal year shall does not revert to the treasury, but shall remain in said the fund and such the moneys shall be expendable after appropriation by the Legislature in ensuing fiscal years.
(d) Each hospital's assessment shall be treated as an allowable expense by the board.
(e) The board is empowered to withhold rate approvals, certificates of need and rural health system loans and grants if any such fees remain unpaid, unless exempted under subsection (g), section four, article two-d of this chapter.
§16-29B-10. Jurisdiction of the board.

(a) Notwithstanding any other provision of state law, after the first day of July, one thousand nine hundred eighty-four two thousand one, the jurisdiction of the board as to rates for health services care shall extend to all hospitals as defined herein doing business in the state of West Virginia (with the exception of hospitals owned and operated by the federal government) is terminated.
(b) Those costs or charges standards and quality of services associated with individual health care providers or health care provider groups providing inpatient or outpatient services under a contractual agreement with hospitals (excluding simple admitting privileges) shall be are under the jurisdiction of the board. The jurisdiction of the board shall does not extend to the regulation of rates of standards and quality of services of private health care providers or health care groups providing inpatient or outpatient services under a contractual agreement with hospitals when the provision of such the service is outside the hospital setting, and shall does not extend to the regulation of rates of all other private health care providers practicing outside the hospital setting: Provided, That such practice outside of the hospital setting is not found to be an evasion of the purposes of this article.
NOTE: The purpose of this bill is to abolish the West Virginia Health Care Authority and to create in its place a Health Care Quality Standards Authority. It provides for the composition of the new authority, its compensation and meetings and management. The bill also repeals provisions of the article relating to rate setting authority of the board.

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