Current through Register Vol. 42, No. 5, February 29, 2024
(1) For purposes of this rule:
(a) the term "Mandatory Report" shall include
every annual report required to be filed with SHPDA by statute or rule and any
other reporting requirement imposed by these rules or the State Health
Plan that is not clearly identified therein as optional. The term
shall not include discovery that may be authorized by the Certificate of Need
Review Board or an Administrative Law Judge as part of a contested case
proceeding or fair hearing, which shall be subject to such requirements as
authorized under the Alabama Administrative Procedure Act or other
regulations.
(b) For purposes of
this rule only:
1. a "rural health care
provider" is a provider or applicant or hospital which is designated by the
United States government Health Care Financing Administration (now Centers for
Medicare and Medicaid Services) as rural, as specified in the SHPDA statutes at
Code of Ala. 1975, § 22-21 -260(12);
and
2. a "small provider" is:
(i) a hospital or other health care provider
providing in-patient care which is not a rural provider and has less than 65
licensed beds;
(ii) a health care
provider holding CON authority solely to provide in-home services, such as
in-home hospice or home health service, which holds CON authority to provide
such in-home care in (a) an area of six counties or less, which does not
include Jefferson, Madison, Mobile or Montgomery County; or
(I) three counties or less, which includes
Jefferson, Madison, Mobile or Montgomery County; or
(iii) any ambulatory surgery center, multi-
or single specialty, performing procedures four (4) days a week or
less;
(iv) any other health care
provider which does not provide in-patient care and which holds a CON
authorizing health care services to be provided at a single location.
(v) For purposes of this subsection (2), a
health care provider's CON authority shall be aggregated with all other CON
authority held by entities under common ownership and control, as defined in
Code of Ala. 1975, § 22-21 -270(e). In addition,
a health care provider shall not be considered a "small provider" if any entity
under common ownership and control holds CON authority for a facility or
service that would not qualify for the small provider exception on a standalone
basis. For illustration only:
(I) A business
entity holds a CON to provide home health care services in six counties, which
do not include Jefferson, Madison, Mobile or Montgomery County. It is under
common ownership and control with two other business entities which each hold
CON authority in two counties to provide the same service. None of these
affiliated entities would be considered a "small provider" for purposes of the
rule.
(II) A business entity
holding a CON to provide methadone treatment at a single location in Alabama is
under common control and ownership with another methadone clinic holding CON
authority. None of these affiliated entities would quality as a "small
provider" under this rule.
(III) A
non-rural hospital with less than 65 licensed beds is under common ownership
and control with a business entity holding CON authority to provide ambulatory
surgical service. None of these affiliated entities would be considered a
"small provider" for purposes of this rule.
(c) When computing any time period
stated in days or a longer unit of time, the Agency or health care reporter
shall, for the purposes of this rule:
1.
exclude the day of the event that triggers the period;
2. count every day, including intermediate
Saturdays, Sundays, and legal holidays; and
3. include the last day of the period, but if
the last day is a Saturday, Sunday, or legal holiday, the period continues to
run until the end of the next day that is not a Saturday, Sunday, or legal
holiday.
(2)
The filing of a Mandatory Report shall be deemed received and filed on the date
of electronic submission to the Agency, pursuant to SHPDA Rule
410-1-3-.09.
(a) Failure to file or filing Incomplete
Report: Any health care reporter failing to meet a filing deadline for a
Mandatory Report, or who files a Mandatory Report deemed to be materially
incomplete by the State Agency, shall be notified by the State Agency staff
that they are not in compliance with this rule within seven (7) days of the
filing deadline (in the case of a failure to file) or within seven (7) days of
the date of receipt of the filing (in the case of a report deemed materially
incomplete by Agency staff). Such health care reporter shall have sixty (60)
days from the original due date of the report to correct the deficiency. Any
facility that is noncompliant under this rule, either due to failure to file or
due to a filing being deemed materially incomplete, shall be deemed to be in a
probationary status in regard to the enforcement of penalties under this
section for a period not to exceed sixty (60) days from the date of filing
deadline.
(b) Failure of the health
care reporter to bring its report into compliance within the required sixty
(60) days will result in the report being deemed not properly filed and subject
the health care reporter to the administrative penalty provisions of Section 3
applicable to delinquent filings, with such penalties to apply from the
original due date of the report.
(c) SHPDA shall track the total number of
Mandatory Reports that are not filed on or before the initial deadline, as well
as the total number of Mandatory Reports deemed materially incomplete when
initially filed. This information, which shall include the names of the
non-compliant health care reporters, shall be reported to the Certificate of
Need Review Board, the Health Care Information and Data Advisory Council and
the Statewide Health Coordinating Council at their regularly scheduled meetings
immediately following the end of the grace period.
(3) In addition to any other provisions
contained in these rules or the State Health Plan, a health
care reporter that fails to submit a compliant Mandatory Report within any
applicable probationary period under subsection (2)(a), shall be assessed a
penalty equal to:
(a) A flat fee of $1,000
for a non-rural health care provider and $500 for a rural health care provider
or small provider, plus
(b) An
additional penalty of $100 for non-rural health care providers and $50 for
rural and small health care providers for each day of delinquency, calculated
from the day after the due date for filing (without regard to any probationary
period) through the date of filing, up to a maximum penalty of $10,000 for
non-rural health care providers (except for small providers) and $5,000 for
rural health care providers and small providers.
(4) A delinquent Mandatory Report must meet
the requirements of Section 2 above and be accompanied by payment of any
administrative penalty prescribed in Section 3 above in order to be deemed
received and filed with the Agency. Such payment shall be submitted in
accordance with SHPDA Rule
410-1-3-.09,
including the provisions related to the submission of fees.
(5) The Executive Director may waive
imposition of a penalty under this rule only upon a written finding that a
timely filing was rendered impossible due to an act of God comparable to (a) an
electrical outage or weather emergency applicable to all businesses in the area
of the health care reporter; (b) the unanticipated closure of SHPDA offices
(other than state holidays or weekends); or (c) an outage rendering SHPDA's
filing system inoperable. Any such waiver shall extend only to the period of
time that the filing was rendered impossible by the qualifying circumstances.
The Executive Director shall advise the Certificate of Need Review Board of the
status of all waiver requests at its regular monthly meeting.
(6) A health care provider who is
non-compliant under the terms of this rule may not participate in the
Certificate of Need review process, either as an applicant for a Certificate of
Need or in opposition to a Certificate of Need application (through
intervention or other statements in opposition), (without regard to the
probationary period set forth in Section 2(a)). A health care provider shall
maintain compliance from the date of the initial filing of such provider's
application or opposition and for the duration of such provider's participation
in the administrative and/or judicial process. A provider deemed non-compliant
due to a Mandatory Report being deemed materially incomplete by Agency staff or
for filing after the due date shall have seven (7) days from the date of
notification of such deficiency to bring such report into compliance prior to
being disqualified from any pending proceeding in which the provider is a
party.
(7) A health care reporter
required to file a Mandatory Report shall maintain a current listing with the
Agency of the name, title, phone number and e-mail address of at least two
individuals designated as the contact of record for purposes of all reports
filed with the Agency and shall designate at least one such contact person as
the primary contact in each report that is filed. The failure to maintain a
current contact listing shall not constitute grounds for the waiver of any
penalties imposed under this rule.
Author: Alva M. Lambert
Statutory Authority:
Code of Ala.
1975, §§ 22-4 -34,
22-4-35,
22-4-37.
