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.
2016 Public Acts regarding the Office of Health Care Access
AN ACT CONCERNING MATTERS AFFECTING PHYSICIANS, HEALTH CARE FACILITIES AND MEDICAL FOUNDATIONS.
Section 2 revises the definition of a “captive professional entity” as follows: a partnership, professional corporation, limited liability company or other entity formed to render professional services in which a partner, a member, a shareholder or a beneficial owner is a physician, directly or indirectly, employed by, controlled by, subject to the direction of, or otherwise designated by (A) a hospital, [or] (B) a hospital system, (C) a medical school, (D) a medical foundation, organized pursuant to subsection (a) of section 33-182bb, as amended by this act, or (E) any entity that controls, is controlled by or is under common control with, whether through ownership, governance, contract or otherwise, another person, entity or organization described in subparagraphs (A) to (D), inclusive, of this subdivision;
Section 7 revises the information to be submitted to OHCA on an annual basis by medical foundations as follows: (1) a statement of its mission, (2) the name and address of the organizing members, (3) the name and specialty of each physician employed by or acting as an agent of the medical foundation, (4) the location or locations where each such physician practices, (5) a description of the services [it provides,] provided at each such location, (6) a description of any significant change in its services during the preceding year, (7) a copy of the medical foundation's governing documents and bylaws, (8) the name and employer of each member of the board of directors, and (9) other financial information as reported on the medical foundation's most recently filed Internal Revenue Service return of organization exempt from income tax form, or any replacement form adopted by the Internal Revenue Service, or, if such medical foundation is not required to file such form, information substantially similar to that required by such form.
2015 Public Acts regarding the Office of Health Care Access
Public Act 15-146
AN ACT CONCERNING HOSPITALS, INSURERS AND HEALTH CARE CONSUMERS
Section 2 of Public Act 15-146 has an effective date of October 1, 2015 and mandates that, no later than July 1, 2016, OHCA post on its website and report the following to the Connecticut Health Insurance Exchange: (1) The fifty most frequently occurring inpatient primary diagnoses and procedures in the state; (2) the fifty most frequently provided outpatient procedures performed in the state; (3) the twenty-five most frequent surgical procedures performed in the state; and (4) the twenty-five most frequent imaging procedures performed in the state.
Section 13 of Public Act 15-146 has an effective date of October 1, 2015.
Subsection (j)(3) requires that a copy of written notices regarding facility fees which must be provided to patients pursuant to Subsection (j)(1)-(2) must also be filed with OHCA and OHCA will post such notices on its website.
Subsection (j)(4) provides that, after January 1, 2016, no hospital, health system or hospital-based facility shall collect a facility fee for services provided at a hospital-based facility subject to this section until at least thirty days after written notice is mailed to the patient or a copy of such notice is filed with the Office of Health Care Access, whichever is later.
Subsection (l)(1)-(2) requires each hospital and health system to report the following to OHCA on or before July 1, 2016: (A) the name and location of each facility owned or operated by the hospital or health system that provides services for which a facility fee is charged or billed, (B) the number of patient visits at each such facility for which a facility fee was charged or billed, (C) the number, total amount and range of allowable facility fees paid at each such facility by Medicare, Medicaid or under private insurance policies, (D) for each facility, the total amount of revenue received by the hospital or health system derived from facility fees, (E) the total amount of revenue received by the hospital or health system from all facilities derived from facility fees, (F) a description of the ten procedures or services that generated the greatest amount of facility fee revenue and, for each such procedure or service, the total amount of revenue received by the hospital or health system derived from facility fees, and (G) the top ten procedures for which facility fees are charged based on patient volume. This subsection further requires OHCA to post said information on its website.
Subsection (d)(2) requires all parties to group practice transactions described in subsection (c) of 19a-486i to file a written notice of such transaction with OHCA within 30 days after the effective date of the transaction and OHCA will post such notice on its website.
Subsection (i) requires each hospital and hospital system to file with OHCA, on an annual basis beginning December 31, 2015, a written report describing each affiliation with another hospital or hospital system. The report must include: (1) The name and address of each party to the affiliation; (2) a description of the nature of the relationship among the parties to the affiliation; (3) the names of the business entities that provide services as part of the affiliation and the address for each location where such services are provided; (4) a description of the services provided at each such location; and (5) the primary service area served by each such location.
Section 28 of Public Act 15-146 has an effective date of July 1, 2015 and modifies the certificate of need criteria by eliminating the review of a project’s impact upon the cost effectiveness of providing access to services provided under the Medicaid program. This section also specifies additional criteria OHCA must consider when reviewing a certificate of need application involving the transfer of ownership of a hospital after December 1, 2015. Furthermore, this section requires the hiring of a post-transfer compliance officer for certain hospital ownership transfers. The new criteria and the use of a post-transfer compliance officer are only applicable to certificate of need applications filed after December 1, 2015 for hospital transfers of ownership involving a not-for-profit purchaser. For transfers of ownership involving a for-profit purchaser, the new criteria and the use of a post-transfer compliance officer are applicable if a determination letter is filed with the office after December 1, 2015.
Section 29 of Public Act 15-146 has an effective date of July 1, 2015 and requires OHCA to retain an independent consultant to conduct a cost and market impact review for any certificate of need application filed after December 1, 2015 where (1) an application for a certificate of need filed pursuant to section 19a-638 of the general statutes involves the transfer of ownership of a hospital and (2) the purchaser is a hospital, whether located within or outside the state, that had net patient revenue for fiscal year 2013 in an amount greater than one billion five hundred million dollars, or a hospital system, whether located within or outside the state, that had net patient revenue for fiscal year 2013 in an amount greater than one billion five hundred million dollars or any person that is organized or operated for profit. The transacting parties are given the opportunity to respond in writing to the findings of the cost and market impact review. This section specifies that the costs associated with conducting the cost and market impact review are to be paid by the purchaser of the hospital.
Section 30 of Public Act 15-146 has an effective date of July 1, 2015 and mandates that certain information be provided in any certificate of need application involving the transfer of ownership of a hospital. Specifically, the applicant must submit the following to OHCA: (A) a plan demonstrating how health care services will be provided by the new hospital for the first three years following the transfer of ownership of the hospital, including any consolidation, reduction, elimination or expansion of existing services or introduction of new services, and (B) the names of persons currently holding a position with the hospital to be purchased or the purchaser as an officer, director, board member or senior manager, whether or not such person is expected to hold a position with the hospital after completion of the transfer of ownership of the hospital and any salary, severance, stock offering or any financial gain, current or deferred, such person is expected to receive as a result of, or in relation to, the transfer of ownership of the hospital.
This section also requires OHCA to hold a public hearing for any certificate of need application involving the transfer of ownership of a hospital that is filed after December 1, 2015.
Section 31 of Public Act 15-146 has an effective date of July 1, 2015 and provides that a public hearing held in accordance with section 19a-639a satisfies the hearing required for hospital ownership transfers involving for-profit entities.
Section 33 requires hospitals and health systems to now report the following to OHCA as a component of its Annual Filings due by February 28 of each year: Salaries and fringe benefits for the ten highest paid health system employees; and the salaries paid to health system employees by each joint venture, partnership, subsidiary and related corporation
This section also requires each hospital that is a party to a transfer of ownership of a hospital for which a certificate of need is issued to include in its annual report due February 28 of each year, any salary, severance payment, stock offering or other financial gain realized by each officer, director, board member or senior manager of the hospital as a result of such transaction.
Section 34 of Public Act 15-146 has an effective date of July 1, 2015 and requires OHCA, by January 1, 2016 and within available appropriations, to report its recommendations on eliminating certain certificate of need requirements and instituting an expedited automatic approval for certain certificate of need applications.
Section 35 of Public Act 15-146 has an effective date of July 1, 2015 and allows OHCA to extend the review period for certificate of need applications involving for-profit transfers of ownership in order to complete a cost and market impact review.
Section 37 of Public Act 15-146 has an effective date of July 1, 2015 and requires certificate of need review for the transfer of ownership of a large group practice.
Section 39 of Public Act 15-146 has an effective date of July 1, 2015 and provides that a certificate of need issued by the office shall not be required where such scanner is a replacement for a scanner that was previously acquired through certificate of need approval or a certificate of need determination.
Section 40 of Public Act 15-146 has an effective date of July 1, 2015 and allows a health system to submit to OHCA one report that includes the audited financial statements for each specialty hospital within the health system (this relates to the hospitals other than acute care general or children’s hospitals).
Public Act 15-242
AN ACT CONCERNING VARIOUS REVISIONS TO THE PUBLIC HEALTH STATUTES
Section 70 of Public Act 15-242 has an effective date of July 1, 2015 and allows a health system to submit to OHCA one statement that includes the audited financial statements for each acute care general or children’s hospital within the health system, due by February 28 of each year as part of the Hospital Annual Reporting Process.
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 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 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 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 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, and the transfer will take place on or before September 1, 2014.
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 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 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 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 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
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
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.
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.
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.
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.
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