Missouri SB 906: Modifies provisions of law relating to health care facilities and certificates of need

Bill Text

SECOND REGULAR SESSION
SENATE BILL NO. 906
99TH GENERAL ASSEMBLY
INTRODUCED BY SENATOR CUNNINGHAM.
Read 1st time January 10, 2018, and ordered printed.
ADRIANE D. CROUSE, Secretary.
5500S.03I
AN ACT
To repeal sections 197.300, 197.305, 197.310, 197.312, 197.315, 197.316, 197.318,
197.320, 197.325, 197.326, 197.327, 197.330, 197.335, 197.340, 197.366,
197.367, and 208.225, RSMo, and to enact in lieu thereof seventeen new
sections relating to health care facilities, with existing penalty provisions.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Sections 197.300, 197.305, 197.310, 197.312, 197.315, 197.316,
2 197.318, 197.320, 197.325, 197.326, 197.327, 197.330, 197.335, 197.340, 197.366,
3 197.367, and 208.225, RSMo, are repealed and seventeen new sections enacted in
4 lieu thereof, to be known as sections 197.300, 197.305, 197.310, 197.312, 197.315,
5 197.316, 197.318, 197.320, 197.323, 197.325, 197.326, 197.327, 197.330, 197.335,
6 197.340, 197.367, and 208.225, to read as follows:
197.300. Sections 197.300 to [197.366] 197.367 shall be known as the
2 "Missouri Certificate of Need Law".
197.305. As used in sections 197.300 to [197.366] 197.367, the following
2 terms mean:
3 (1) "Affected persons", the person proposing the development of a new
4 institutional health service, the public to be served, and health care facilities
5 within the service area in which the proposed new health care service is to be
6 developed;
7 (2) ["Agency", the certificate of need program of the Missouri department
8 of health and senior services;
9 (3)] "Capital expenditure", an expenditure by or on behalf of a health care
10 facility which, under generally accepted accounting principles, is not properly
11 chargeable as an expense of operation and maintenance;
EXPLANATION--Matter enclosed in bold-faced brackets [thus] in this bill is not enacted and is
intended to be omitted in the law.

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12 [(4)] (3) "Certificate of need", a written certificate issued by the
13 [committee] department setting forth the [committee's] department's
14 affirmative finding that a proposed project sufficiently satisfies the criteria
15 prescribed for such projects by sections 197.300 to [197.366] 197.367;
16 (4) "Department", the department of health and senior services;
17 (5) "Develop", to undertake those activities which on their completion will
18 result in the offering of a new institutional health service or the incurring of a
19 financial obligation in relation to the offering of such a service;
20 (6) "Expenditure minimum" shall mean:
21 (a) For beds in existing or proposed health care facilities licensed
22 pursuant to chapter 198 and long-term care beds in a hospital as described in
23 subdivision (3) of subsection 1 of section 198.012, six hundred thousand dollars
24 in the case of capital expenditures[, or four hundred thousand dollars in the case
25 of major medical equipment,]; provided[, however], that prior to January 1, 2003,
26 the expenditure minimum for beds in such a facility and long-term care beds in
27 a hospital described in section 198.012 shall be zero, subject to the provisions of
28 subsection 7 of section 197.318;
29 (b) For beds [or equipment] in a long-term care hospital meeting the
30 requirements described in 42 CFR[, Section] 412.23(e), the expenditure minimum
31 shall be zero; and
32 (c) For health care facilities, new institutional health services, or beds not
33 described in paragraph (a) or (b) of this subdivision, one million dollars in the
34 case of capital expenditures[, excluding major medical equipment, and one million
35 dollars in the case of medical equipment];
36 (7) "Health care facilities" shall mean:
37 (a) Facilities licensed under chapter 198;
38 (b) Long-term care beds in a hospital as described in subdivision
39 (3) of subsection 1 of section 198.012;
40 (c) Long-term care hospitals or beds in a long-term care hospital
41 meeting the requirements described in 42 CFR 412.23(e); and
42 (d) Construction of a new hospital as the term "hospital" is
43 defined in section 197.020;
44 (8) "Health service area", a geographic region appropriate for the effective
45 planning and development of health services, determined on the basis of factors
46 including population and the availability of resources, consisting of a population
47 of not less than five hundred thousand or more than three million;

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48 [(8) "Major medical equipment", medical equipment used for the provision
49 of medical and other health services;]
50 (9) "New institutional health service":
51 (a) The development of a new health care facility costing in excess of the
52 applicable expenditure minimum;
53 (b) The acquisition, including acquisition by lease, of any health care
54 facility[, or major medical equipment costing] in excess of the expenditure
55 minimum;
56 (c) Any capital expenditure by or on behalf of a health care facility in
57 excess of the expenditure minimum;
58 (d) P