Title of Regulation: 12VAC5-221. Regulations Governing Cooperative Agreements (amending 12VAC5-221-40).

Statutory Authority: § 32.1-12 of the Code of Virginia.

Effective Date: November 14, 2018.

Agency Contact: Robert Payne, Director, Office of Licensure and Certification, Virginia Department of Health, 9960 Mayland Drive, Suite 401, Richmond, VA 23233, telephone (804) 367-2109, FAX (804) 527-4502, or email robert.payne@vdh.virginia.gov.

Summary:

Pursuant to Chapter 371 of the 2018 Acts of Assembly, the amendments establish requirements associated with Department of Health approval of cooperative agreements between hospitals, including reimbursement of the State Health Commissioner for costs necessary to examine, review, and supervise a cooperative agreement; reasonable notice to the parties of a cooperative agreement of the anticipated costs of the agreement, such as costs associated with the use of experts and consultants and the proposed scope of the work; provision by the parties of the cooperative agreement of alternatives to the use of experts and consultants; commissioner review of the alternatives; and recordkeeping and reporting of costs and reimbursements.

12VAC5-221-40. Fee schedule.

A. Fees shall be remitted only by certified check, cashier's check, bank money order, or other methods approved by the department. Fees shall be made payable to the department.

B. The application fee shall be $50,000 and shall be due to the department upon its receipt of a recommendation for approval from the authority.

C. If the commissioner should determine after review of the application that the actual cost incurred by the department is less than $50,000, the applicant shall be reimbursed the amount that is greater than the actual cost. If the commissioner should determine that the actual cost incurred by the department is greater than $50,000, the applicant shall pay any additional amounts due as instructed by the department. The application fee shall not exceed $75,000.

D. The commissioner shall be reimbursed from applicants seeking approval of a cooperative agreement for all reasonable and actual costs incurred by the commissioner in the commissioner's review of the application, including costs of experts and consultants retained by the commissioner. The commissioner shall incur only those costs necessary to adequately review the application as determined in the commissioner's sole discretion. The commissioner shall maintain detailed records of all costs incurred for which reimbursement is sought.

E. The commissioner shall determine the activities needed to actively supervise an approved cooperative agreement and may incur only those expenses necessary for such supervision as determined in the commissioner's sole discretion. The commissioner shall be entitled to reimbursement from the parties for all reasonable and actual costs incurred by the commissioner in the supervision of an approved cooperative agreement, including costs of experts and consultants retained by the commissioner. Prior to contracting with experts or consultants, the commissioner shall provide reasonable notice to the parties describing the proposed scope of work and anticipated costs of such experts and consultants. The parties shall be given a reasonable time period to provide to the commissioner possible alternatives to the use of such experts and consultants. The commissioner shall consider information submitted by the parties in determining whether to retain an expert or consultant.

F. The commissioner shall maintain detailed records of all costs incurred for which the commissioner seeks reimbursement from the parties. The commissioner shall provide the parties a written quarterly report detailing all costs incurred by the commissioner related to the supervision of the cooperative agreement for which the commissioner seeks reimbursement. This report shall be provided to the parties within 30 days of the end of each quarter. Within 30 days of receipt of a request for reimbursement, the parties shall make payment to the department.