32.1-102.2 - Regulations.

§ 32.1-102.2. Regulations.

A. The Board shall promulgate regulations which are consistent with thisarticle and:

1. Shall establish concise procedures for the prompt review of applicationsfor certificates consistent with the provisions of this article which mayinclude a structured batching process which incorporates, but is not limitedto, authorization for the Commissioner to request proposals for certainprojects. In any structured batching process established by the Board,applications, combined or separate, for computed tomographic (CT) scanning,magnetic resonance imaging (MRI), positron emission tomographic (PET)scanning, radiation therapy, sterotactic radiotherapy, proton beam therapy,or nuclear imaging shall be considered in the radiation therapy batch. Asingle application may be filed for a combination of (i) radiation therapy,sterotactic radiotherapy and proton beam therapy, and (ii) any or all of thecomputed tomographic (CT) scanning, magnetic resonance imaging (MRI),positron emission tomographic (PET) scanning, and nuclear medicine imaging;

2. May classify projects and may eliminate one or more or all of theprocedures prescribed in § 32.1-102.6 for different classifications;

3. May provide for exempting from the requirement of a certificate projectsdetermined by the Commissioner, upon application for exemption, to be subjectto the economic forces of a competitive market or to have no discernibleimpact on the cost or quality of health services;

4. Shall establish specific criteria for determining need in rural areas,giving due consideration to distinct and unique geographic, socioeconomic,cultural, transportation, and other barriers to access to care in such areasand providing for weighted calculations of need based on the barriers tohealth care access in such rural areas in lieu of the determinations of needused for the particular proposed project within the relevant health systemsarea as a whole;

5. May establish, on or after July 1, 1999, a schedule of fees forapplications for certificates to be applied to expenses for theadministration and operation of the certificate of public need program. Suchfees shall not be less than $1,000 nor exceed the lesser of one percent ofthe proposed expenditure for the project or $20,000. Until such time as theBoard shall establish a schedule of fees, such fees shall be one percent ofthe proposed expenditure for the project; however, such fees shall not beless than $1,000 or more than $20,000; and

6. Shall establish an expedited application and review process for anycertificate for projects reviewable pursuant to subdivision 8 of thedefinition of "project" in § 32.1-102.1. Regulations establishing theexpedited application and review procedure shall include provisions fornotice and opportunity for public comment on the application for acertificate, and criteria pursuant to which an application that wouldnormally undergo the review process would instead undergo the fullcertificate of public need review process set forth in § 32.1-102.6.

B. The Board shall promulgate regulations providing for time limitations forschedules for completion and limitations on the exceeding of the maximumcapital expenditure amount for all reviewable projects. The Commissionershall not approve any such extension or excess unless it complies with theBoard's regulations. However, the Commissioner may approve a significantchange in cost for an approved project that exceeds the authorized capitalexpenditure by more than 20 percent, provided the applicant has demonstratedthat the cost increases are reasonable and necessary under all thecircumstances and do not result from any material expansion of the project asapproved.

C. The Board shall also promulgate regulations authorizing the Commissionerto condition approval of a certificate on the agreement of the applicant toprovide a level of care at a reduced rate to indigents or accept patientsrequiring specialized care. In addition, the Board's licensure regulationsshall direct the Commissioner to condition the issuing or renewing of anylicense for any applicant whose certificate was approved upon such conditionon whether such applicant has complied with any agreement to provide a levelof care at a reduced rate to indigents or accept patients requiringspecialized care.

(1982, c. 388; 1991, c. 561; 1993, c. 704; 1996, c. 1050; 1999, cc. 899, 922,926; 2003, cc. 61, 72; 2007, c. 502; 2009, c. 175.)