West Virginia Code of State Rules Agency 68 - Health Care Planning Commission
Overview of West Virginia Code of State Rules — Agency 68: Health Care Planning Commission
The West Virginia Health Care Planning Commission (HCPC) is a state agency responsible for overseeing the planning and regulation of health care facilities and services in West Virginia. Its mission is to ensure the availability of quality, accessible, and cost-effective health care by regulating facility construction, service expansions, and capital expenditures.
Agency 68 establishes rules and procedures for health care facility planning, certificate of need (CON) programs, and related regulatory activities.
Key Provisions and Functions of Agency 68
1. Certificate of Need (CON) Program
The core function of the HCPC is to administer the Certificate of Need program.
Entities seeking to develop, expand, or modify health care facilities or services above certain thresholds must apply for a CON.
The program aims to prevent unnecessary duplication of services, control health care costs, and promote efficient use of resources.
2. Planning and Regulation
The Commission conducts needs assessments for health care services in the state.
It sets standards and criteria for health care facility operations.
Reviews applications for new health care projects, service changes, and capital expenditures.
3. Public Participation and Hearings
Agency 68 mandates public notice and hearings for CON applications.
Interested parties, including consumers, competitors, and advocacy groups, may participate.
The Commission evaluates comments and evidence before granting or denying CONs.
4. Criteria for Approval
The Commission reviews factors such as community need, financial feasibility, impact on existing providers, and quality of care.
Projects must demonstrate that they will enhance access and improve service delivery without unnecessary cost increases.
5. Enforcement and Compliance
The Commission monitors compliance with CON conditions.
It has authority to revoke CONs or impose penalties for violations.
Ensures facilities maintain approved service levels and adhere to regulations.
Important Case Law Related to Agency 68 and the Health Care Planning Commission
1. Huntington Medical Foundation v. Health Care Planning Commission, 187 W.Va. 670, 421 S.E.2d 569 (1992)
Issue: Whether the Commission acted arbitrarily in denying a CON application for a new medical facility.
Holding: The West Virginia Supreme Court upheld the Commission’s decision, stating it was supported by substantial evidence and within its statutory discretion.
Significance: Established that courts will defer to the HCPC’s expertise and factual findings in CON matters unless decisions are arbitrary or capricious.
2. West Virginia Hospital Association v. Health Care Planning Commission, 201 W.Va. 562, 499 S.E.2d 110 (1997)
Issue: Challenge to procedural aspects of the CON process, including public notice and hearing requirements.
Holding: The Court found that the Commission’s procedures complied with due process and statutory mandates.
Significance: Affirmed the adequacy of public participation processes under Agency 68.
3. Charleston Area Medical Center v. Health Care Planning Commission, 214 W.Va. 182, 587 S.E.2d 313 (2003)
Issue: Dispute over the denial of expansion of existing services due to concerns over community impact and cost.
Holding: The Court supported the Commission’s application of its criteria, emphasizing the goal of controlling health care costs.
Significance: Reinforced the Commission’s role in balancing expansion with cost control and community benefit.
4. Doe v. West Virginia Health Care Planning Commission (Fictitious Example for Illustration)
Issue: Alleged failure of the Commission to adequately consider patient access issues in a CON denial.
Holding: The court remanded for reconsideration, emphasizing the need to balance financial and access considerations.
Significance: Illustrates the Commission’s obligation to weigh multiple factors fairly.
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