Sec. 19a-613. Powers and duties. Data collection.
Sec. 19a-639c. Proposed relocation of a health care facility. Policies, procedures and regulations.
Sec. 19a-613. Powers and duties. Data collection. (a) The Health Systems Planning Unit may employ the most effective and practical means necessary to fulfill the purposes of this chapter, which may include, but need not be limited to:
(1) Collecting patient-level outpatient data from health care facilities, as defined in section 19a-630, and birth centers, as defined in section 19a-490;
(2) Establishing a cooperative data collection effort, across public and private sectors, to assure that adequate health care personnel demographics are readily available; and
(3) Performing the duties and functions as enumerated in subsection (b) of this section.
(b) The unit shall: (1) Authorize and oversee the collection of data required to carry out the provisions of this chapter; (2) oversee and coordinate health system planning for the state; (3) monitor health care costs; and (4) implement and oversee health care reform as enacted by the General Assembly.
(c) The executive director of the Office of Health Strategy, or any person the executive director designates, may conduct a hearing and render a final decision in any case when a hearing is required or authorized under the provisions of any statute dealing with the Health Systems Planning Unit.
(May Sp. Sess. P.A. 94-3, S. 8, 28; P.A. 95-257, S. 37, 58; June 18 Sp. Sess. P.A. 97-8, S. 28, 88; P.A. 98-36, S. 3; 98-87, S. 2; P.A. 99-172, S. 1, 7; P.A. 05-151, S. 1; Sept. Sp. Sess. P.A. 09-3, S. 3; P.A. 18-91, S. 16; P.A. 23-147, S. 5.)
History: May Sp. Sess. P.A. 94-3 effective July 1, 1994; P.A. 95-257 deleted former Subsec. (b) re responsibility for a state health regulation and financing plan, and former Subsec. (d) re a working group to study a regional health care plan, relettered the remaining Subsecs. accordingly and amended new Subsec. (b) by requiring coordination with the Health Care Data Institute and by adding new Subdiv. (4) re continuing the functions and duties of chapter 368c and renumbering the remaining Subdiv. and added new Subsec. (c) re hearings and decisions by a designee, effective July 1, 1995; June 18 Sp. Sess. P.A. 97-8 made technical changes in Subsec. (b) reflecting the abolishment of the Connecticut Health Care Data Institute, effective July 1, 1997; P.A. 98-36 made a technical correction, changing reference to sections to “this chapter”; P.A. 98-87 amended Subsec. (a) to add Subdivs. (1) and (2) re collecting data, changed “shall” to “may” and changed section reference to chapter reference; P.A. 99-172 made a technical change in Subsec. (c) and added Subsecs. (d) re graduate medical education and (e) re reports, effective June 23, 1999; P.A. 05-151 deleted Subsecs. (d) and (e) re graduate medical education reporting requirements; Sept. Sp. Sess. P.A. 09-3 amended Subsec. (c) by substituting Commissioner of Public Health for Commissioner of Health Care Access, effective October 6, 2009; P.A. 18-91 amended Subsec. (a) by replacing “Office of Health Care Access” with “Health Systems Planning Unit”, amended Subsec. (b) by replacing “office” with “unit” and amended Subsec. (c) by replacing references to Commissioner of Public Health with references to executive director of the Office of Health Strategy, and replaced “Office of Health Care Access” with “Health Systems Planning Unit”, effective May 14, 2018; P.A. 23-147 amended Subsec. (a)(1) by deleting reference to institutions and adding reference to birth centers.
| (Return to Chapter Table of Contents) |
(Return to List of Chapters) |
(Return to List of Titles) |
Sec. 19a-633. (Formerly Sec. 19a-149). Investigative powers. Notice of violation. Hearing. Cease and desist order. Enforcement by Attorney General. (a) The executive director, or any agent authorized by such executive director to conduct any inquiry, investigation or hearing under the provisions of this chapter, shall have power to administer oaths and take testimony under oath relative to the matter of inquiry or investigation. At any hearing ordered by the unit, the executive director or such agent having authority by law to issue such process may subpoena witnesses and require the production of records, papers and documents pertinent to such inquiry. If any person disobeys such process or, having appeared in obedience thereto, refuses to answer any pertinent question put to such person by the executive director or such executive director's authorized agent or to produce any records and papers pursuant thereto, the executive director or such executive director's agent may apply to the superior court for the judicial district of Hartford or for the judicial district wherein the person resides or wherein the business has been conducted, or to any judge of said court if the same is not in session, setting forth such disobedience to process or refusal to answer, and said court or such judge shall cite such person to appear before said court or such judge to answer such question or to produce such records and papers.
(b) If the executive director or such agent has received information and has a reasonable belief that any person, health care facility or institution has violated or is violating any provision of this chapter, or any regulation or order of the unit, the executive director or such agent may issue a notice pursuant to this section. The unit shall notify the person, health care facility or institution against whom such order is issued by first class mail or personal service. The notice shall include: (1) A reference to the sections of the general statutes, regulations of Connecticut state agencies or orders alleged or believed to have been violated; (2) a short and plain language statement of the matters asserted or charged; (3) a description of the activity alleged to have violated a statute or regulation identified pursuant to subdivision (1) of this subsection; (4) a statement concerning the right to a hearing of such person, health care facility or institution; and (5) a statement that such person, health care facility or institution may, not later than ten business days after receipt of such notice, make a written request for a hearing on the matters asserted, to be sent to the executive director or such agent.
(c) The person, health care facility or institution to whom such notice is provided pursuant to subsection (b) of this section may, not later than ten business days after receipt of the notice, make written application to the unit to request a hearing to demonstrate that such violation has not occurred, a certificate of need was not required, or each required certificate of need was obtained. A failure to make a timely request for a hearing shall result in the office issuing a cease and desist order. Each hearing held under this subsection shall be conducted as a contested case pursuant to chapter 54.
(d) If the unit finds, by a preponderance of the evidence, following a hearing held under subsection (c) of this section that such person, health care facility or institution has violated or is violating any provision of this chapter, or any regulation or order of the unit, the unit shall issue a cease and desist order to such person, health care facility or institution that shall be considered a final decision subject to appeal to the Superior Court in accordance with section 4-183.
(e) Any cease and desist order issued under this section may be enforced by the Attorney General pursuant to section 19a-642.
(P.A. 73-117, S. 7, 31; P.A. 78-280, S. 2, 6, 127; P.A. 88-230, S. 1, 12; P.A. 90-98, S. 1, 2; P.A. 93-142, S. 4, 7, 8; P.A. 95-220, S. 4–6; 95-257, S. 44, 58; P.A. 18-91, S. 23; P.A. 23-171, S. 10.)
History: P.A. 78-280 replaced “county” with “judicial district” and “Hartford county” with “judicial district of Hartford-New Britain”; Sec. 19-73g transferred to Sec. 19a-149 in 1983; P.A. 88-230 replaced “judicial district of Hartford-New Britain” with “judicial district of Hartford”, effective September 1, 1991; P.A. 90-98 changed the effective date of P.A. 88-230 from September 1, 1991, to September 1, 1993; P.A. 93-142 changed the effective date of P.A. 88-230 from September 1, 1993, to September 1, 1996, effective June 14, 1993; P.A. 95-220 changed the effective date of P.A. 88-230 from September 1, 1996, to September 1, 1998, effective July 1, 1995; P.A. 95-257 replaced variants of “commission” with “commissioner” or “office”, effective July 1, 1995; Sec. 19a-149 transferred to Sec. 19a-633 in 1997; P.A. 18-91 replaced “commissioner” with “executive director”, replaced “office” with “unit”, and made technical changes, effective May 14, 2018; P.A. 23-171 designated existing provisions as Subsec. (a) and added Subsec. (b) re notice of violation of any provision of this chapter or regulation or order of the unit, Subsec. (c) re request for hearing, Subsec. (d) re issuance of cease and desist order and Subsec. (e) re enforcement by Attorney General.
| (Return to Chapter Table of Contents) |
(Return to List of Chapters) |
(Return to List of Titles) |
Sec. 19a-638. (Formerly Sec. 19a-154). Certificate of need. When required and not required. Request for unit determination. Policies, procedures and regulations. (a) A certificate of need issued by the unit shall be required for:
(1) The establishment of a new health care facility;
(2) A transfer of ownership of a health care facility;
(3) A transfer of ownership of a large group practice to any entity other than a (A) physician, or (B) group of two or more physicians, legally organized in a partnership, professional corporation or limited liability company formed to render professional services and not employed by or an affiliate of any hospital, medical foundation, insurance company or other similar entity;
(4) The establishment of a freestanding emergency department;
(5) The termination of inpatient or outpatient services offered by a hospital, including, but not limited to, the termination by a short-term acute care general hospital or children's hospital of inpatient and outpatient mental health and substance abuse services;
(6) The establishment of an outpatient surgical facility, as defined in section 19a-493b, or as established by a short-term acute care general hospital;
(7) The termination of surgical 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 short-term acute care general hospital, provided termination of outpatient surgical services due to (A) insufficient patient volume, or (B) the termination of any subspecialty surgical service, shall not require certificate of need approval;
(8) The termination of an emergency department by a short-term acute care general hospital;
(9) The establishment of cardiac services, including inpatient and outpatient cardiac catheterization, interventional cardiology and cardiovascular surgery;
(10) The acquisition of computed tomography scanners, magnetic resonance imaging scanners, positron emission tomography scanners or positron emission tomography-computed tomography scanners, by any person, physician, provider, short-term acute care general hospital or children's hospital, except (A) as provided for in subdivision (22) of subsection (b) of this section, and (B) a certificate of need issued by the unit 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, including a replacement scanner that has dual modalities or functionalities if the applicant already offers similar imaging services for each of the scanner's modalities or functionalities that will be utilized;
(11) The acquisition of nonhospital based linear accelerators, except a certificate of need issued by the unit shall not be required where such accelerator is a replacement for an accelerator that was previously acquired through certificate of need approval or a certificate of need determination;
(12) An increase in the licensed bed capacity of a health care facility, except as provided in subdivision (23) of subsection (b) of this section;
(13) The acquisition of equipment utilizing technology that has not previously been utilized in the state;
(14) An increase of two or more operating rooms within any three-year period, commencing on and after October 1, 2010, by an outpatient surgical facility, as defined in section 19a-493b, or by a short-term acute care general hospital; and
(15) The termination of inpatient or outpatient services offered by a hospital or other facility or institution operated by the state that provides services that are eligible for reimbursement under Title XVIII or XIX of the federal Social Security Act, 42 USC 301, as amended.
(b) A certificate of need shall not be required for:
(1) Health care facilities owned and operated by the federal government;
(2) The establishment of offices by a licensed private practitioner, whether for individual or group practice, except when a certificate of need is required in accordance with the requirements of section 19a-493b or subdivision (3), (10) or (11) of subsection (a) of this section;
(3) A health care facility operated by a religious group that exclusively relies upon spiritual means through prayer for healing;
(4) Residential care homes, as defined in subsection (c) of section 19a-490, and nursing homes and rest homes, as defined in subsection (o) of section 19a-490;
(5) An assisted living services agency, as defined in section 19a-490;
(6) Home health agencies, as defined in section 19a-490;
(7) Hospice services, as described in section 19a-122b;
(8) Outpatient rehabilitation facilities;
(9) Outpatient chronic dialysis services;
(10) Transplant services;
(11) Free clinics, as defined in section 19a-630;
(12) School-based health centers and expanded school health sites, as such terms are defined in section 19a-6r, community health centers, as defined in section 19a-490a, not-for-profit outpatient clinics licensed in accordance with the provisions of chapter 368v and federally qualified health centers;
(13) A program licensed or funded by the Department of Children and Families, provided such program is not a psychiatric residential treatment facility;
(14) Any nonprofit facility, institution or provider that has a contract with, or is certified or licensed to provide a service for, a state agency or department for a service that would otherwise require a certificate of need. The provisions of this subdivision shall not apply to a short-term acute care general hospital or children's hospital, or a hospital or other facility or institution operated by the state that provides services that are eligible for reimbursement under Title XVIII or XIX of the federal Social Security Act, 42 USC 301, as amended;
(15) A health care facility operated by a nonprofit educational institution exclusively for students, faculty and staff of such institution and their dependents;
(16) An outpatient clinic or program operated exclusively by or contracted to be operated exclusively by a municipality, municipal agency, municipal board of education or a health district, as described in section 19a-241;
(17) A residential facility for persons with intellectual disability licensed pursuant to section 17a-227 and certified to participate in the Title XIX Medicaid program as an intermediate care facility for individuals with intellectual disabilities;
(18) Replacement of existing computed tomography scanners, magnetic resonance imaging scanners, positron emission tomography scanners, positron emission tomography-computed tomography scanners, or nonhospital based linear accelerators, if such equipment was acquired through certificate of need approval or a certificate of need determination, provided a health care facility, provider, physician or person notifies the unit of the date on which the equipment is replaced and the disposition of the replaced equipment, including if a replacement scanner has dual modalities or functionalities and the applicant already offers similar imaging services for each of the equipment's modalities or functionalities that will be utilized;
(19) Acquisition of cone-beam dental imaging equipment that is to be used exclusively by a dentist licensed pursuant to chapter 379;
(20) The partial or total elimination of services provided by an outpatient surgical facility, as defined in section 19a-493b, except as provided in subdivision (6) of subsection (a) of this section and section 19a-639e;
(21) The termination of services for which the Department of Public Health has requested the facility to relinquish its license;
(22) Acquisition of any equipment by any person that is to be used exclusively for scientific research that is not conducted on humans;
(23) On or before June 30, 2026, an increase in the licensed bed capacity of a mental health facility, provided (A) the mental health facility demonstrates to the unit, in a form and manner prescribed by the unit, that it accepts reimbursement for any covered benefit provided to a covered individual under: (i) An individual or group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469; (ii) a self-insured employee welfare benefit plan established pursuant to the federal Employee Retirement Income Security Act of 1974, as amended from time to time; or (iii) HUSKY Health, as defined in section 17b-290, and (B) if the mental health facility does not accept or stops accepting reimbursement for any covered benefit provided to a covered individual under a policy, plan or program described in clause (i), (ii) or (iii) of subparagraph (A) of this subdivision, a certificate of need for such increase in the licensed bed capacity shall be required.
(24) The establishment at harm reduction centers through the pilot program established pursuant to section 17a-673c; or
(25) On or before June 30, 2028, a birth center, as defined in section 19a-490, that is enrolled as a provider in the Connecticut medical assistance program, as defined in section 17b-245g.
(c) (1) Any person, health care facility or institution that is unsure whether a certificate of need is required under this section, or (2) any health care facility that proposes to relocate pursuant to section 19a-639c, shall send a letter to the unit that describes the project and requests that the unit make a determination as to whether a certificate of need is required. In the case of a relocation of a health care facility, the letter shall include information described in section 19a-639c. A person, health care facility or institution making such request shall provide the unit with any information the unit requests as part of its determination process. The unit shall provide a determination within thirty days of receipt of such request.
(d) The executive director of the Office of Health Strategy may implement policies and procedures necessary to administer the provisions of this section while in the process of adopting such policies and procedures as regulation, provided the executive director holds a public hearing prior to implementing the policies and procedures and posts notice of intent to adopt regulations on the office's Internet web site and the eRegulations System not later than twenty days after the date of implementation. Policies and procedures implemented pursuant to this section shall be valid until the time final regulations are adopted.
(e) On or before June 30, 2026, a mental health facility seeking to increase licensed bed capacity without applying for a certificate of need, as permitted pursuant to subdivision (23) of subsection (b) of this section, shall notify the Office of Health Strategy, in a form and manner prescribed by the executive director of said office, regarding (1) such facility's intent to increase licensed bed capacity, (2) the address of such facility, and (3) a description of all services that are being or will be provided at such facility.
(f) Not later than January 1, 2025, the executive director of the Office of Health Strategy shall report to the Governor and, in accordance with the provisions of section 11-4a, to the joint standing committee of the General Assembly having cognizance of matters relating to public health concerning the executive director's recommendations, if any, regarding the establishment of an expedited certificate of need process for mental health facilities.
(P.A. 73-117, S. 13, 31; P.A. 77-192, S. 7, 13; 77-304, S. 2; 77-601, S. 7, 11; P.A. 79-98, S. 1, 4; P.A. 80-73, S. 4; P.A. 81-211; 81-441, S. 1; 81-465, S. 5, 9, 18; P.A. 82-415, S. 15, 18; P.A. 83-215, S. 1, 3; P.A. 86-374, S. 2, 6; P.A. 87-192, S. 1, 3; 87-420, S. 11, 14; P.A. 89-72, S. 1, 5; 89-325, S. 12, 26; P.A. 91-48, S. 1, 4; June Sp. Sess. P.A. 91-8, S. 27, 63; June Sp. Sess. P.A. 91-12, S. 10; P.A. 92-220, S. 1, 2; P.A. 93-229, S. 3, 21; 93-262, S. 1, 17, 87; 93-381, S. 9, 39; 93-406, S. 1, 6; 93-435, S. 59, 95; P.A. 94-236, S. 9, 10; P.A. 95-257, S. 12, 21, 39, 46, 58; P.A. 97-112, S. 2; P.A. 98-150, S. 2, 17; P.A. 02-89, S. 34; P.A. 03-17, S. 1; P.A. 05-75, S. 2; 05-93, S. 1; 05-280, S. 58; P.A. 06-28, S. 1; 06-64, S. 6; 06-196, S. 214; P.A. 08-14, S. 3; P.A. 09-232, S. 92; Sept. Sp. Sess. P.A. 09-3, S. 9; P.A. 10-179, S. 87; P.A. 11-10, S. 1; 11-129, S. 8; 11-183, S. 1; 11-242, S. 80; P.A. 13-139, S. 17; P.A. 14-168, S. 6; P.A. 15-59, S. 4; 15-146, S. 37, 39; P.A. 18-91, S. 25; P.A. 19-118, S. 74; P.A. 22-47, S. 31; P.A. 23-97, S. 4; 23-147, S. 8; 23-171, S. 11.)
History: P.A. 77-192 included state health care facilities or institutions in provisions of section; P.A. 77-304 specified applicability to facilities or institutions which intend to “transfer all or any part of its ownership or control prior to being initially licensed” and specified factors to be considered in review if transfer of ownership or control is proposed; P.A. 77-601 added provisions concerning applicability of provisions to home health care, homemaker-home health aide, or coordination assessment and monitoring agencies and added Subsec. (b) re approval of home health care, homemaker-home health aide or coordination, assessment and monitoring agencies; P.A. 79-98 made provisions applicable to inpatient rehabilitation facilities affiliated with Easter Seal Society; P.A. 80-73 allowed commission to modify requests as well as to grant or deny requests in Subsec. (a); P.A. 81-211 mandated commission approval in Subsec. (a) for decreases in services to medical assistance patients by termination of Medicaid provider agreements; P.A. 81-441 amended the commission on hospitals and health care certificate of need review process by exempting from review outpatient, i.e. “ambulatory”, services provided by a health maintenance organization and by extending review to any facility plan to terminate a health service or to substantially decrease bed capacity; P.A. 81-465 amended Subsec. (a) to exempt home health care and homemaker-home health care agencies from commission review relative to transfers of ownership prior to initial licensure or increased staffing or services, and added provisions, codified by the Revisors as Subsec. (c), re coordination of activities between commission and health systems agencies; P.A. 82-415 eliminated exception for ambulatory service programs by health maintenance organizations from provision requiring submission of request for permission to add a function or service or to increase staff in Subsec. (a); Sec. 19-73l transferred to Sec. 19a-154 in 1983; P.A. 83-215 exempted ambulatory services established and conducted by a health maintenance organization from certificate of need review, provided for a 15-day extension of the 90-day review period if additional information is requested by the commissioner or a motion to approve, modify or deny a request results in a tie vote and authorized the adoption of regulations to establish a schedule for the submission of similar requests; P.A. 86-374 deleted references to coordination, assessment and monitoring agencies, including all of Subsec. (b), relettering Subsec. (c) accordingly; P.A. 87-192 deleted references to 90-day review period and added the provision re extension of the review period for 30 days; P.A. 87-420 deleted references to health systems agency and deleted the provision re coordination of activities with health systems agencies; P.A. 89-72 amended Subsec. (b) to change “shall” to “may” with regard to holding of hearings, adopting of regulations and establishing of a schedule which provides for completed applications pertaining to similar types of services; P.A. 89-325 deleted provisions re the decrease in services to recipients of medical assistance benefits in Subsec. (a); P.A. 91-48 restated Subsec. (a) provision re agencies required to request permission to undertake transfer of ownership or control, to institute additional functions or services or to terminate functions and services or to reduce bed capacity; June Sp. Sess. P.A. 91-8 added Subsecs. (d), (e) and (f) re moratorium on certificate of need for additional nursing home beds, on additional requests for beds from residential facilities for the mentally retarded, and any requests to modify the capital cost or expiration date of approval; June Sp. Sess. P.A. 91-12 amended Subsec. (c) requiring the commission to adopt regulations requiring that applications for certificates be submitted in cycles; P.A. 92-220 amended Subsec. (d) by extending moratorium through June 30, 1994, and adding provision re date by which construction shall begin and date by which nursing home shall be licensed under certificates of need in effect August 1, 1991, amended Subsec. (e) by deleting provision re expiration of approval of additional nursing home beds granted on or before July 1, 1991, and substituting definition of “a continuing care facility which guarantees life care for its residents”, added Subsec. (g) re joint request for merger of certificates of need, added Subsec. (h) re when construction shall be deemed to have begun, added Subsec. (i) re when financing shall be deemed to have been obtained, and added Subsec. (j) re when financing shall be deemed to have been obtained on and after March 1, 1993; P.A. 93-229 added Subsec. (a)(4) re submission of letter of intent, amended Subsec. (b) re exception to 90-day review period, adding language explaining that emergency nature to include compliances with fire, building or life safety code and that the letter of intent may be waived and amended Subsec. (c) to change “shall” to “may” re adoption of regulations, effective June 4, 1993; P.A. 93-262 deleted homemaker-home health aide agencies and added nursing homes, homes for the aged, rest homes and certain residential facilities for the mentally retarded as facilities to which section applies, deleted Subsecs. (d) to (g), inclusive, and (i) re requests for additional nursing home beds, continuing care facilities, requests for beds in residential facilities for the mentally retarded, certificates of need and financing methods, relettering remaining Subsecs. as necessary, effective July 1, 1993; P.A. 93-381 replaced department of health services with department of public health and addiction services, effective July 1, 1993; P.A. 93-406 added Subsecs. (f) and (g) re expiration of certificates of need for nursing home beds, effective June 29, 1993 (Revisor's note: Pursuant to P.A. 93-262, 93-381 and 93-435 references to commissioners and departments of health services and income maintenance were replaced editorially by the Revisors by references to commissioners and departments of public health and addiction services and social services, respectively); P.A. 94-236 deleted former Subsec. (g) regarding nonexpiration of certificate of need if additional beds are used for a continuing care facility, effective June 7, 1994; P.A. 95-257 replaced Commission on Hospitals and Health Care and “commission” with Office of Health Care Access and “office” or “commissioner”, replaced Department of Public Health and Addiction Services with Department of Public Health and deleted reference to a tie vote of the former commission, effective July 1, 1995; Sec. 19a-154 transferred to Sec. 19a-638 in 1997; P.A. 97-112 replaced “home for the aged” with “residential care home”; P.A. 98-150 added reference to exceptions in introductory language of Subsec. (a) and deleted the exceptions throughout section, reworded transfer as Subpara. (A) in Subsec. (a)(1) and added Subparas. (B) and (C), changed “transfer” to “transfer or change” in Subsec. (a)(1), amended Subdiv. (a)(4) by adding “replacement or additional”, adding “or relocation” to “expansion” adding references to change in ownership or control, termination of services or reduction in bed capacity or type, capital expenditure over $1,000,000 and acquisition of specified equipment over $400,000, added “value or expenditure” to Subdiv. (a)(4)(C), changed 90 days to 60 in Subdiv. (a)(4)(E) and added exception re one-time extension, amended Subsec. (b) by adding “new” and “expansion or the termination” to service or function and adding reference to termination or change of ownership throughout Subsec., added “affiliate of such hospital or any combination thereof”, replaced reference to future budget adjustments with Subdivs. (1), (2) and language re exclusion during review period, amended Subsec. (c) by deleting obsolete authority to adopt regulations and made technical changes throughout, effective June 5, 1998; P.A. 02-89 amended Subsec. (a) to replace reference to Sec. 19a-639d with Sec. 19a-639c, reflecting repeal of Sec. 19a-639d by the same public act; P.A. 03-17 amended Subsec. (a)(3) by replacing “decrease” with “reduce” and changed licensed bed capacity to total bed capacity and required notice when letter of intent received in Subsec. (a)(4), made technical changes in Subsec. (b) and added Subsec. (c)(1) to (3) re public hearings on complete certificate of need applications under certain circumstances; P.A. 05-75 added Subsec. (c)(3) by adding Subpara. (A) designator and new Subpara. (B) establishing a 21 calendar day deadline for requesting a public hearing on a completed certificate of need application; P.A. 05-93 amended Subsec. (a)(4) by eliminating, with certain exceptions, the $400,000 capital expenditure threshold for certificate of need review of proposals involving the purchase, lease or donation acceptance of various types of scanning equipment and linear accelerators and by making technical changes, effective July 1, 2005; P.A. 05-280 amended Subsec. (a) by adding reference to Sec. 19a-487a, effective July 1, 2005; P.A. 06-28 amended Subsec. (a)(4) by increasing the capital expenditure threshold and major medical equipment acquisition threshold for certificate of need review to $3,000,000, effective July 1, 2006; P.A. 06-64 amended Subsec. (b) by allowing waiver of letter of intent requirement when a function, service or termination or change of ownership or control is necessary to maintain continued access to health care services provided by a facility or institution, effective July 1, 2006; P.A. 06-196 made technical changes in Subsec. (a)(4), effective June 7, 2006; P.A. 08-14 amended Subsec. (a)(4) by substituting 21 days for 15 business days, substituting 7 days for 5 business days and making technical changes, amended Subsec. (b) by substituting not less than 14 days for at least 10 business days, amended Subsec. (c)(3) by making a technical change, and deleted Subsecs. (d) to (f), effective July 1, 2008; P.A. 09-232 amended Subsec. (a)(1) by deleting “all or part of” in Subpara. (A) and by defining “transfer its ownership or control”, amended Subsec. (a)(4)(B) by substituting “transfer of its ownership or control” for “change in ownership or control” in clause (iii) and by eliminating “cineangiography equipment” in clause (viii) and amended Subsec. (b) by making conforming changes, effective July 1, 2009; Sept. Sp. Sess. P.A. 09-3 amended Subsec. (b) by inserting “or the commissioner's designee”, effective October 6, 2009; P.A. 10-179 replaced former Subsecs. (a) to (c) with new Subsecs. (a) to (d) re when certificate of need is and is not required, letters to office for determination re whether certificate is required and authority of Commissioner of Public Health to implement policies and procedures while in process of adopting regulations; P.A. 11-10 amended Subsec. (a)(8) by adding reference to exception provided in Subsec. (b)(23) and added Subsec. (b)(23) exempting acquisition of equipment used exclusively for scientific research not conducted on humans from certificate of need requirements, effective May 24, 2011; P.A. 11-129 amended Subsec. (b)(17) to substitute “persons with intellectual disability” for “the mentally retarded”; P.A. 11-183 amended Subsec. (a) by requiring certificate of need for termination of inpatient or outpatient services offered by a hospital in Subdiv. (4), adding new Subdiv. (6) requiring certificate of need for termination of surgical services by certain facilities providing such services and redesignating existing Subdivs. (6) to (12) as Subdivs. (7) to (13), amended Subsec. (b) by substituting “persons with intellectual disability” for “the mentally retarded” in Subdiv. (17), deleting former Subdiv. (20) which excluded termination of inpatient or outpatient services offered by a hospital from certificate of need requirements, redesignating existing Subdivs. (21) to (23) as Subdivs. (20) to (22) and adding exception re Subsec. (a)(6) in Subdiv. (20), and made technical changes, effective July 13, 2011; P.A. 11-242 amended Subsec. (a) by adding provision, codified by the Revisors as Subdiv. (14), requiring certificate of need for termination of inpatient or outpatient services offered by certain hospitals, facilities or institutions operated by the state, effective July 13, 2011; P.A. 13-139 amended Subsec. (b)(17) by substituting “individuals with intellectual disabilities” for “the mentally retarded”; P.A. 14-168 amended Subsec. (a) by adding new Subdiv. (3) re transfer of ownership of a group practice and redesignating existing Subdivs. (3) to (14) as Subdivs. (4) to (15) and amended Subsec. (b)(2) by making a conforming change, effective July 1, 2014; P.A. 15-59 amended Subsec. (b)(12) by adding references to expanded school health sites and definitions in Sec. 19a-6r; P.A. 15-146 amended Subsec. (a)(3) by replacing “group practice” with “large group practice”, designating existing provision re physician as Subpara. (A), designating existing provision re group as Subpara. (B) and amending same to replace provision re group of physicians and exception with provision re group of two or more physicians legally organized to render professional services and not employed by or an affiliate of certain entities, and amended Subsec. (a)(10) by designating existing provisions re Subsec. (b)(22) as Subpara. (A) and adding Subpara. (B) re replacement scanner, effective July 1, 2015; P.A. 18-91 replaced references to office with references to unit, and amended Subsec. (d) to replace references to Commissioner of Public Health with references to executive director of Office of Health Strategy, replace “prints notice of intent to adopt regulations in the Connecticut Law Journal” with “posts notice of intent to adopt regulations on the office's Internet web site and the eRegulations System”, and delete provision re adoption of final regulations by December 31, 2011, effective May 14, 2018; P.A. 19-118 amended Subsec. (b)(4) by adding “as defined in subsection (c) of section 19a-490, and”, and replacing reference to Sec. 19a-490(c) with reference to Sec. 19a-490(o), effective July 9, 2019; P.A. 22-47 amended Subsec. (a)(12) by adding reference to an exception to the certificate of need requirement for an increase in licensed bed capacity and Subsec. (b) by adding Subdiv. (23) re an exception to the certificate of need requirement for an increase in licensed bed capacity of certain mental health facilities and added Subsec. (e) re notification of the Office of Health Strategy by a mental health facility seeking to increase licensed bed capacity and Subsec. (f) re reporting by executive director of Office of Health Strategy, effective May 23, 2022; P.A. 23-97 amended Subsec. (b) by adding Subdiv. (24) re establishment of harm reduction centers, effective June 28, 2023; P.A. 23-147 amended Subsec. (b) by adding Subdiv. (24) codified by the Revisors as Subdiv. (25), re an exception to certificate of need requirement for birth centers enrolled as providers in Connecticut medical assistance program and making a conforming change, effective January 1, 2024; P.A. 23-171 amended Subsec. (a) by adding exception for replacement scanner with dual modalities or functionalities in Subdiv. (10)(B) and by adding exception for replacement accelerators in Subdiv. (11), amended Subsec. (b)(18) by replacing “imaging equipment” with “computed tomography scanners, magnetic resonance imaging scanners, positron emission tomography scanners, positron emission tomography-computed tomography scanners, or nonhospital based linear accelerators,” and adding provision re replacing scanners with dual modalities or functionalities and amended Subsec. (c) to require unit to provide determination within 30 days of receipt of request.
| (Return to Chapter Table of Contents) |
(Return to List of Chapters) |
(Return to List of Titles) |
Sec. 19a-639a. Certificate of need application process. Issuance of decision. Public hearings. Retention of independent consultant. Policies, procedures and regulations. (a) An application for a certificate of need shall be filed with the unit in accordance with the provisions of this section and any regulations adopted by the Office of Health Strategy. The application shall address the guidelines and principles set forth in (1) subsection (a) of section 19a-639, and (2) regulations adopted by the department. The applicant shall include with the application a nonrefundable application fee based on the cost of the project. The amount of the fee shall be as follows: (A) One thousand dollars for a project that will cost not greater than fifty thousand dollars; (B) two thousand dollars for a project that will cost greater than fifty thousand dollars but not greater than one hundred thousand dollars; (C) three thousand dollars for a project that will cost greater than one hundred thousand dollars but not greater than five hundred thousand dollars; (D) four thousand dollars for a project that will cost greater than five hundred thousand dollars but not greater than one million dollars; (E) five thousand dollars for a project that will cost greater than one million dollars but not greater than five million dollars; (F) eight thousand dollars for a project that will cost greater than five million dollars but not greater than ten million dollars; and (G) ten thousand dollars for a project that will cost greater than ten million dollars.
(b) Prior to the filing of a certificate of need application, the applicant shall (1) publish notice that an application is to be submitted to the unit (A) in a newspaper having a substantial circulation in the area where the project is to be located, and (B) on the applicant's Internet web site in a clear and conspicuous location that is easily accessible by members of the public, (2) request the publication of notice (A) in at least two sites within the affected community that are commonly accessed by the public, such as a town hall or library, and (B) on any existing Internet web site of the municipality or local health department, and (3) submit such notice to the unit for posting on such unit's Internet web site. Such newspaper notice shall be published for not less than three consecutive days, with the final date of consecutive publication occurring not later than twenty days prior to the date of filing of the certificate of need application, and contain a brief description of the nature of the project and the street address where the project is to be located. Postings in the affected community and on the applicant's Internet web site shall remain until the decision on the application is rendered. The unit shall not invalidate any notice due to changes or removal of the notice from a community Internet web site of which the applicant has no control. An applicant shall file the certificate of need application with the unit not later than ninety days after publishing notice of the application in a newspaper in accordance with the provisions of this subsection. The unit shall not accept the applicant's certificate of need application for filing unless the application is accompanied by the application fee prescribed in subsection (a) of this section and proof of compliance with the publication requirements prescribed in this subsection.
(c) (1) Not later than five business days after receipt of a properly filed certificate of need application, the unit shall publish notice of the application on its Internet web site. Not later than thirty days after the date of filing of the application, the unit may request such additional information as the unit determines necessary to complete the application. In addition to any information requested by the unit, if the application involves the transfer of ownership of a hospital, as defined in section 19a-639, the applicant shall submit to the unit (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 defined in section 19a-639, 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.
(2) The applicant shall, not later than sixty days after the date of the unit's request, submit any requested information and any information required under this subsection to the unit. If an applicant fails to submit such information to the unit within the sixty-day period, the unit shall consider the application to have been withdrawn.
(3) The unit shall make reasonable efforts to limit the requests for additional information to two such requests and, in all cases, cease all requests for additional information not later than six months after receiving the application.
(d) Upon deeming an application complete, the unit shall provide notice of this determination to the applicant and to the public in accordance with regulations adopted by the department. In addition, the unit shall post such notice on its Internet web site and notify the applicant not later than five days after deeming the application complete. The date on which the unit posts such notice on its Internet web site shall begin the review period. Except as provided in this subsection, (1) the review period for an application deemed complete shall be ninety days from the date on which the unit posts such notice on its Internet web site; and (2) the unit shall issue a decision on an application deemed complete prior to the expiration of the ninety-day review period in matters without a public hearing. The review period for an application deemed complete that involves a transfer of a large group practice, as described in subdivision (3) of subsection (a) of section 19a-638, when the offer was made in response to a request for proposal or similar voluntary offer for sale, shall be sixty days from the date on which the unit posts notice on its Internet web site. Upon request or for good cause shown, the unit may extend the review period for a period of time not to exceed sixty days. If the review period is extended, the unit shall issue a decision on the completed application prior to the expiration of the extended review period. If the unit holds a public hearing concerning a completed application in accordance with subsection (e) or (f) of this section, the unit shall issue a decision on the completed application not later than sixty days after the date the unit closes the public hearing record.
(e) Except as provided in this subsection, the unit shall hold a public hearing on a properly filed and completed certificate of need application if three or more individuals or an individual representing an entity with five or more people submits a request, in writing, that a public hearing be held on the application. For a properly filed and completed certificate of need application involving a transfer of ownership of a large group practice, as described in subdivision (3) of subsection (a) of section 19a-638, when an offer was made in response to a request for proposal or similar voluntary offer for sale, a public hearing shall be held if twenty-five or more individuals or an individual representing twenty-five or more people submits a request, in writing, that a public hearing be held on the application. Any request for a public hearing shall be made to the unit not later than thirty days after the date the unit deems the application to be complete.
(f) (1) The unit shall hold a public hearing with respect to each certificate of need application filed pursuant to section 19a-638, after December 1, 2015, that concerns any transfer of ownership involving a hospital. Such hearing shall be held in the municipality in which the hospital that is the subject of the application is located.
(2) The unit may hold a public hearing with respect to any certificate of need application submitted under this chapter. The unit shall provide not less than two weeks' advance notice to the applicant, in writing, and to the public by publication in a newspaper having a substantial circulation in the area served by the health care facility or provider. In conducting its activities under this chapter, the unit may hold hearings with respect to applications of a similar nature at the same time. The applicant shall post a copy of the unit's hearing notice on the applicant's Internet web site in a clear and conspicuous location that is easily accessible by members of the public. Such applicant shall request the publication of notice in at least two sites within the affected community that are commonly accessed by the public, such as a town hall or library, as well as on any existing Internet web site of the municipality or local health department. The unit shall not invalidate any notice due to changes or removal of the notice from a community Internet web site of which the applicant has no control.
(g) For applications submitted on or after October 1, 2023, the unit may retain an independent consultant with expertise in the specific area of health care that is the subject of the application filed by an applicant if the review and analysis of an application cannot reasonably be conducted by the unit without the expertise of an industry analyst or other actuarial consultant. The unit shall submit bills for independent consultant services to the applicant. Such applicant shall pay such bills not later than thirty days after receipt of such bills. Such bills shall be a reasonable amount per application. The provisions of chapter 57 and sections 4-212 to 4-219, inclusive, and 4e-19 shall not apply to any retainer agreement executed pursuant to this subsection.
(h) The executive director of the Office of Health Strategy may implement policies and procedures necessary to administer the provisions of this section while in the process of adopting such policies and procedures as regulation, provided the executive director holds a public hearing prior to implementing the policies and procedures and posts notice of intent to adopt regulations on the office's Internet web site and the eRegulations System not later than twenty days after the date of implementation. Policies and procedures implemented pursuant to this section shall be valid until the time final regulations are adopted.
(P.A. 98-150, S. 4, 17; June 30 Sp. Sess. P.A. 03-3, S. 90; P.A. 05-93, S. 5; 05-151, S. 5; 05-168, S. 4; P.A. 06-28, S. 3; P.A. 07-217, S. 84; P.A. 08-14, S. 2; P.A. 09-232, S. 94; P.A. 10-179, S. 89; P.A. 11-242, S. 25; P.A. 12-170, S. 2; P.A. 14-168, S. 8; P.A. 15-146, S. 30; 15-242, S. 42; P.A. 18-91, S. 27; P.A. 19-56, S. 9; P.A. 22-118, S. 225; P.A. 23-171, S. 12.)
History: P.A. 98-150 effective June 5, 1998 (Revisor's note: In codifying this section the Revisors editorially changed a reference in Subsec. (b) to “… September thirty.” to “… September thirtieth.”); June 30 Sp. Sess. P.A. 03-3 amended Subsec. (a) to delete references to residential care home and make a technical change, effective August 20, 2003; P.A. 05-93 amended Subsec. (a) by adding exception re Sec. 19a-639(c) and making a technical change, and added Subsec. (c), exempting health care facilities, institutions and providers that purchase, lease or accept donation of certain scanning equipment or linear accelerators on or before July 1, 2005, or that obtain certificate of need approval or a determination that a certificate of need is not required on or before said date, effective July 1, 2005; P.A. 05-151 amended Subsec. (b) by requiring biennial, rather than annual, registration of exempt institutions; P.A. 05-168 added new Subsec. (d) exempting from certificate of need review, at office's discretion, proposals involving the purchase or operation of an electronic medical records system on or after October 1, 2005; P.A. 06-28 amended Subsec. (c)(1) by restricting exemption from certificate of need review to proposals involving certain equipment in operation on or before July 1, 2006, effective May 8, 2006; P.A. 07-217 made a technical change in Subsec. (c), effective July 12, 2007; P.A. 08-14 amended Subsec. (b) by substituting 14 days for 10 business days and making a technical change and added Subsec. (e) re additional capital expenditures that are exempt from certificate of need review, effective April 29, 2008; P.A. 09-232 added Subsec. (a)(12) re program licensed or funded by Department of Children and Families, amended Subsec. (c) by eliminating “cineangiography equipment” and added Subsec. (f) re exemption for outpatient services provided at alternative location within primary service area, effective July 1, 2009; P.A. 10-179 replaced former Subsecs. (a) to (f) with new Subsecs. (a) to (g) re certificate of need application process, time frames for review and issuance of decision by office, public hearing process and authority of Commissioner of Public Health to implement policies and procedures while in process of adopting regulations; P.A. 11-242 amended Subsec. (b) by restructuring existing provisions and adding Subdiv. and Subpara. designators, by requiring applicant to file certificate of need application with office not later than 90 days after publishing notice of application and by making technical changes, and amended Subsec. (c) by eliminating requirement that certificate of need application be filed with Office of the Secretary of the State; P.A. 12-170 amended Subsecs. (a) and (d) by replacing references to office with references to Department of Public Health re regulations and amended Subsec. (d) by replacing provision requiring office to issue a decision not later than 60 days after date of public hearing with provision requiring office to issue a decision not later than 60 days after date the office closes the public hearing record; P.A. 14-168 amended Subsec. (d) by adding provision re review period for transfer of a group practice and amended Subsec. (e) by adding provisions re application involving transfer of ownership of a group practice, effective July 1, 2014; P.A. 15-146 amended Subsec. (c) by designating existing provisions re notice of application and request for information as Subdiv. (1) and amending same by adding provisions re application involving transfer of ownership of a hospital, designating existing provisions re submission of requested information as Subdiv. (2) and amending same by adding reference to information required and making technical changes, amended Subsecs. (d) and (e) by replacing “group practice” with “large group practice”, amended Subsec. (f) by adding Subdiv. (1) re public hearing for application involving transfer of ownership of a hospital and designating existing provisions re public hearing as Subdiv. (2), amended Subsec. (g) by replacing reference to Connecticut Law Journal with reference to department's Internet web site and the eRegulations System and deleting provision re date for adoption of final regulations, effective July 1, 2015; P.A. 15-242 amended Subsecs. (c) and (d) by adding “Internet” re web site and making a technical change; P.A. 18-91 replaced references to office with references to unit, amended Subsec. (a) to replace “Department of Public Health” with “Office of Health Strategy”, and amended Subsec. (g) to replace references to Commissioner of Public Health with references to executive director of the Office of Health Strategy, replace “prints notice” with “posts notice”, and replace “department's” with “office's”, effective May 14, 2018; P.A. 19-56 replaced “hearing on” with “hearings with respect to” in Subsec. (f)(2), effective June 28, 2019; P.A. 22-118 amended Subsec. (a) by removing the $500 application fee and adding an application fee scale based on the cost of the project, effective May 7, 2022; P.A. 23-171 amended Subsec. (b) by inserting new Subdiv. (1) and Subpara. (A) designators, adding new Subdiv. (2) re requesting publication of notice, adding new Subdiv. (3) re submission of notice to the unit, deleting existing Subdiv. (1) and (2) designators, deleting existing Subdiv. (1)(A), requiring newspaper notice for not less than 3 consecutive days, with final date of consecutive publication occurring not later than 20 days prior to the date of filing of the application, and requiring postings to remain until a decision is rendered, amended Subsec. (c) by adding Subdiv. (3) re reasonable efforts by unit to limit requests for additional information, amended Subsec. (d) by requiring unit to notify the applicant not later than 5 days after deeming the application complete and making technical changes, amended Subsec. (e) by making a technical change, amended Subsec. (f)(2) by requiring applicant to post a copy of unit's hearing notice on applicant's Internet web site and to request publication of a notice in at least 2 sites within the affected community, added new Subsec. (g) re retention of independent consultant, and redesignated existing Subsec. (g) as Subsec. (h).
| (Return to Chapter Table of Contents) |
(Return to List of Chapters) |
(Return to List of Titles) |
Sec. 19a-639c. Proposed relocation of a health care facility. Policies, procedures and regulations. (a) Any health care facility that proposes to relocate a facility shall submit a letter to the unit, as described in subsection (c) of section 19a-638. In addition to the requirements prescribed in said subsection (c), in such letter the health care facility shall demonstrate to the satisfaction of the unit that the population served by the health care facility and the payer mix will not substantially change as a result of the facility's proposed relocation. If the facility is unable to demonstrate to the satisfaction of the unit that the population served and the payer mix will not substantially change as a result of the proposed relocation, the health care facility shall apply for certificate of need approval pursuant to subdivision (1) of subsection (a) of section 19a-638, in order to effectuate the proposed relocation. The unit shall provide a determination not later than thirty days after receipt of such letter.
(b) The executive director of the Office of Health Strategy may implement policies and procedures necessary to administer the provisions of this section while in the process of adopting such policies and procedures as regulation, provided the executive director holds a public hearing prior to implementing the policies and procedures and posts notice of intent to adopt regulations on the office's Internet web site and the eRegulations System not later than twenty days after the date of implementation. Policies and procedures implemented pursuant to this section shall be valid until the time final regulations are adopted.
(P.A. 98-150, S. 7, 17; June Sp. Sess. P.A. 98-1, S. 94, 121; P.A. 05-93, S. 6; P.A. 06-28, S. 5; 06-64, S. 9; 06-196, S. 245; P.A. 09-232, S. 96; P.A. 10-179, S. 91; P.A. 18-91, S. 29; P.A. 23-171, S. 13.)
History: P.A. 98-150 effective June 5, 1998; June Sp. Sess. P.A. 98-1 made a technical change by adding the first reference to “provider” to “health care facility, institution”; P.A. 05-93 extended waiver provisions to certain scanning equipment, rather than to “imaging equipment”, and made technical and conforming changes, effective July 1, 2005; P.A. 06-28 amended Subdiv. (3) by increasing maximum permissible replacement value of major medical equipment and certain scanners and linear accelerators eligible for waiver from certificate of need review from $2,000,000 to $3,000,000, effective July 1, 2006; P.A. 06-64 deleted former Subdiv. (2) which limited waivers for replacement equipment to equipment or accelerators not exceeding a specific value and redesignated existing Subdiv. (3) as Subdiv. (2), effective July 1, 2006; P.A. 06-196 made technical changes, effective June 7, 2006; P.A. 09-232 eliminated “cineangiography equipment”, added new Subdiv. (2) re waiver of certificate of need requirements when replacing equipment that did not require certificate of need for original acquisition and redesignated existing Subdiv. (2) as Subdiv. (3), effective July 1, 2009; P.A. 10-179 replaced former provisions with Subsecs. (a) and (b) re process for relocation of a health care facility and authority of Commissioner of Public Health to implement policies and procedures while in process of adopting regulations; P.A. 18-91 amended Subsec. (a) by replacing “office” with “unit”, and amended Subsec. (b) by replacing references to Commissioner of Public Health with references to executive director of the Office of Health Strategy, replacing “prints notice of intent to adopt regulations in the Connecticut Law Journal” with “posts notice of intent to adopt regulations on the office's Internet web site and the eRegulations System”, and deleting provision re adoption of final regulations by December 31, 2011, effective May 14, 2018; P.A. 23-171 amended Subsec. (a) by requiring unit to provide a determination not later than 30 days after receipt of letter.
| (Return to Chapter Table of Contents) |
(Return to List of Chapters) |
(Return to List of Titles) |
Sec. 19a-653. (Formerly Sec. 19a-167j). Failure to file a certificate of need or data or information or negligent failure to comply with a settlement agreement. Civil penalty. Notice. Extension. Hearing. Appeal. Deduction from Medicaid payments. (a) Any person or health care facility or institution that is required to file a certificate of need for any of the activities described in section 19a-638, and any person or health care facility or institution that is required to file data or information under any public or special act or under this chapter or sections 19a-486 to 19a-486h, inclusive, or any regulation adopted or order issued under this chapter or said sections, and negligently fails to seek certificate of need approval for any of the activities described in section 19a-638, or to so file within prescribed time periods, and any person or health care facility or institution that has agreed to fully resolve a certificate of need application through settlement and negligently fails to comply with any term or condition enumerated in the settlement agreement, shall be subject to a civil penalty of up to one thousand dollars a day for each day such person or health care facility or institution conducts any of the described activities without certificate of need approval as required by section 19a-638, for each day such information is missing, incomplete or inaccurate or for each day any condition of a settlement agreement is not met. Any civil penalty authorized by this section shall be imposed by the Office of Health Strategy in accordance with subsections (b) to (e), inclusive, of this section.
(b) If the Office of Health Strategy has reason to believe that a violation has occurred for which a civil penalty is authorized by subsection (a) of this section or subsection (e) of section 19a-632, it shall notify the person or health care facility or institution by first-class mail or personal service. The notice shall include: (1) A reference to the sections of the statute, regulation or settlement agreement involved; (2) a short and plain statement of the matters asserted or charged; (3) a statement of the amount of the civil penalty or penalties to be imposed; (4) the initial date of the imposition of the penalty; and (5) a statement of the party's right to a hearing.
(c) The person or health care facility or institution to whom the notice is addressed shall have fifteen business days from the date of mailing of the notice to make written application to the unit to (1) request a hearing to contest the imposition of the penalty, (2) request an extension of time to file the required data, or (3) comply with enumerated conditions of an agreed settlement. A failure to make a timely request for a hearing or an extension of time to file the required data or a denial of a request for an extension of time shall result in a final order for the imposition of the penalty. All hearings under this section shall be conducted pursuant to sections 4-176e to 4-184, inclusive. The Office of Health Strategy may grant an extension of time for filing the required data or mitigate or waive the penalty upon such terms and conditions as, in its discretion, it deems proper or necessary upon consideration of any extenuating factors or circumstances.
(d) A final order of the Office of Health Strategy assessing a civil penalty shall be subject to appeal as set forth in section 4-183 after a hearing before the unit pursuant to subsection (c) of this section, except that any such appeal shall be taken to the superior court for the judicial district of New Britain. Such final order shall not be subject to appeal under any other provision of the general statutes. No challenge to any such final order shall be allowed as to any issue which could have been raised by an appeal of an earlier order, denial or other final decision by the office.
(e) If any person or health care facility or institution fails to pay any civil penalty under this section, after the assessment of such penalty has become final the amount of such penalty may be deducted from payments to such person or health care facility or institution from the Medicaid account.
(P.A. 88-230, S. 1, 12; P.A. 89-371, S. 28, 31; P.A. 90-98, S. 1, 2; P.A. 93-142, S. 4, 7, 8; May 25 Sp. Sess. P.A. 94-1, S. 120, 130; P.A. 95-160, S. 55, 69; 95-220, S. 4–6; 95-257, S. 39, 58; P.A. 96-139, S. 12, 13; P.A. 98-150, S. 8, 17; P.A. 99-172, S. 5, 7; 99-215, S. 24, 29; P.A. 05-151, S. 10; P.A. 06-28, S. 6; P.A. 09-232, S. 97; Sept. Sp. Sess. P.A. 09-3, S. 16; P.A. 10-179, S. 93; P.A. 11-242, S. 87; P.A. 13-234, S. 148; P.A. 18-91, S. 39; P.A. 23-171, S. 14.)
History: May 25 Sp. Sess. P.A. 94-1 removed obsolete language and added reference to Secs. 19a-170 to 19a-170g, inclusive, in Subsec. (a), effective July 1, 1994 (Revisor's note: The last sentence of Subsec. (a) which reads “Any civil penalty authorized by this section shall be imposed by the Commission on Hospitals and Health Care in accordance with subsection (b) of this section.” was omitted from the amendment to Subsec. (a) but in the absence of any indication that the General Assembly intended to delete this sentence it has been treated as a clerical error and reinstated by the Revisors); P.A. 95-160 amended Subsec. (a) to add health care providers who own, operate, or seek to acquire CAT scan or medical imaging equipment, increase the penalty from $250 to $1,000, made technical changes, broadened application of section to all of chapter 368c and 368z, deleted Subsecs. (b) to (d) and replaced them with new (b) to (e) re procedure for application of penalty, effective June 1, 1995 (Revisor's note: P.A. 88-230, 90-98, 93-142 and 95-220 authorized substitution of “judicial district of Hartford” for “judicial district of Hartford-New Britain” in 1995 public and special acts, effective September 1, 1998); P.A. 95-257 replaced Commission on Hospitals and Health Care with Office of Health Care Access, effective July 1, 1995; P.A. 96-139 changed effective date of P.A. 95-160 but without affecting this section; Sec. 19a-167j transferred to Sec. 19a-653 in 1997; P.A. 98-150 amended Subsec. (a) by deleting “health care facility or institution” concerning owning, operating or seeking to acquire equipment and adding it concerning filing data, added “or information under any public or special act”, adding linear accelerators and adding Subdiv. (2) re request as to whether certificate of need is required and made technical changes, effective June 5, 1998; P.A. 99-172 added reference to “person” in Subsecs. (a), (c) and (e) and made technical changes in Subsecs. (b), (c) and (e), effective June 23, 1999; P.A. 99-215 replaced “judicial district of Hartford” with “judicial district of New Britain” in Subsec. (d), effective June 29, 1999; P.A. 05-151 amended Subsec. (a) by extending the civil penalty for failure to file certificate of need data or information with office to non-profit hospitals seeking to become for-profit hospitals and to “any person or health care facility or institution”, rather than “any health care provider”, and by broadening the type of major medical and scanning equipment that triggers the filing requirement, amended Subsec. (c) by extending the deadline for requesting a public hearing to contest the penalty from 10 calendar days to 15 business days after office mails the notice of violation and penalty to be imposed, and made conforming changes in Subsecs. (b), (c) and (e); P.A. 06-28 amended Subsec. (a)(1) by increasing the major medical equipment acquisition threshold from $400,000 to $3,000,000, effective July 1, 2006; P.A. 09-232 amended Subsec. (a)(1) by eliminating “cineangiography equipment”, effective July 1, 2009; Sept. Sp. Sess. P.A. 09-3 amended Subsec. (a)(1) by substituting “Department of Public Health” for “Office of Health Care Access” and amended Subsecs. (b), (c) and (d) by substituting “Department of Public Health” for “office”, effective October 6, 2009; P.A. 10-179 amended Subsec. (a) by deleting portion of former Subdiv. (1) re filing requirements for medical equipment costing over $3,000,000 and certain equipment developed or introduced on or after October 1, 2005, by adding provisions re civil penalties for wilful failure to seek certificate of need approval under Sec. 19a-638 and re exception to civil penalties for failure to complete inventory questionnaire required by Sec. 19a-634, and by deleting former Subdiv. (2) re request for office determination; P.A. 11-242 amended Subsec. (b) by adding reference to civil penalty authorized by Sec. 19a-632(e), effective July 1, 2011; P.A. 13-234 amended Subsec. (a) by deleting provision re exemption from civil penalties for failure to complete inventory questionnaire; P.A. 18-91 replaced references to Department of Public Health with references to Office of Health Strategy, and amended Subsecs. (c) and (d) to replace “office” with “unit”, effective May 14, 2018; P.A. 23-171 amended Subsec. (a) by replacing “which wilfully” with “and negligently” and adding provisions re negligent failure to comply with settlement agreement, Subsec. (b) by adding reference to “settlement agreement” and Subsec. (c) by adding Subdiv. (3) re complying with conditions of settlement agreement and making technical changes.
| (Return to Chapter Table of Contents) |
(Return to List of Chapters) |
(Return to List of Titles) |