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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 22. HEALTH |
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SubTilte 22-B. PUBLIC HEALTH AND MEDICINE |
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Chapter 22-B40. CERTIFICATES OF NEED |
Section 22-B4000. GENERAL PROVISIONS
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4000.1The provisions of Chapters 40 through 45 shall apply to a review of an application for a Certificate of Need (CON) required under Section 7 of the District of Columbia Health Services Planning Program Re-Establishment Act of 1996 as amended (Act), effective April 9, 1997 (D.C. Law 11-191; D.C. Official Code § 44-406).
4000.2 No person shall undertake any activity for which a CON is required if:
(a) The original term of the CON has expired and the person has not obtained an extension pursuant to Section 4007; or
(b) The Director has revoked the CON pursuant to Section 4010 or Section 4308 of this title.
4000.3 A CON shall be valid for up to three (3) years.
4000.4A CON shall be valid upon its issuance. However, because the Director may revoke or modify a CON after reconsideration or an appeal decision, a CON holder proceeds solely at its own risk during the period when reconsideration or appeal may be requested and during any period that any reconsideration or appeal is in process.
4000.5The issuance of a CON, if required under the Act, shall be a condition precedent to the issuance of any license, permit, or any other type of official approval (except zoning approval) by any agency or officer or employee of the District government that is necessary for the project in addition to the CON.
4000.6A CON shall be for a specific site, except that a proposed change of site within the same Advisory Neighborhood Commission shall not require further CON review if the change is made before the project is implemented. Any proposed change in the location of an approved service or facility outside the same Advisory Neighborhood Commission shall require application for a new CON.
4000.7 For the purpose of Subsection 4000.6, the term "official approval" shall mean final approval by the District government subject only to appeal.
4000.8SHPDA shall not be required to issue a CON before an administrative budget review body approves a budget request that is under consideration by the Council because the project relies on the appropriation of funds from the District budget.
4000.9For the purposes of Chapters 40 through 45 the term “major medical equipment” includes:
(a) Equipment used for providing medical or health services acquired by lease, purchase, donation, or other comparable arrangement by or on behalf of a health care facility, or by or on behalf of any private group practice of diagnostic radiology or radiation therapy, for which the fair market value exceeds one million five hundred thousand dollars ($1,500,000) adjusted from time to time to reflect changes in the Consumer Price Index; or
(b) A single piece of diagnostic or therapeutic equipment acquired by lease, purchase, donation, or other comparable arrangement by or on behalf of a physician or group of physicians, or an independent operator of the equipment, for which the fair market value exceeds two hundred and fifty thousand dollars ($250,000) adjusted from time to time to reflect changes in the Consumer Price Index.
4000.10For the purposes of Chapters 40 through 45 the term “major medical equipment” excludes medical equipment acquired by or on behalf of a clinical laboratory to provide clinical laboratory services when it is independent of a physician’s office or a hospital and satisfies the requirements of § 1861(s)(10) and (11) of the Social Security Act, approved August 14, 1935 (49 Stat. 420; 42 U.S.C. 1395x(s)).
4000.11For the purposes of Chapters 40 through 45 an entity is “acquiring effective control” if it does any of the following:
(a) Transferring, assigning, or otherwise disposing of fifty percent (50%) or more of the stock, voting rights thereunder, ownership interest, or operating assets of a corporation or other entity that is a health care facility (HCF) or is the operator or owner of an HCF;
(b) Engaging in a transaction that results in any person, or any group of persons acting in concert, owning or controlling, directly or indirectly, fifty percent (50%) or more of the stock, voting rights thereunder, ownership interest, or operating assets of a corporation or other entity that is an HCF;
(c) Engaging in a transaction that results in any person, or any group of persons acting in concert, having the ability to elect or cause the election of a majority of the board of directors of a corporation that is an HCF; or
(d) Engaging in a conversion that results in the selling, transferring, leasing, exchanging, conveying, or otherwise disposing of, directly or indirectly, all the assets or a material amount of the assets, of a nonprofit HCF to a for-profit entity, whether a corporation, mutual benefit corporation, limited liability partnership, general partnership, joint venture, or sole proprietorship, including an entity that results from, or is created in connection with, the conversion.
4000.12For the purposes of Chapters 40 through 45 a facility is considered a “diagnostic health care facility” if the facility is not operated by a hospital and is not the offices of a private physician or dentist, unless one (1) or more pieces of major medical equipment is located within the office, and is:
(a) A diagnostic imaging center accredited by the American College of Radiology whose primary business is providing diagnostic imaging services to the public;
(b) A cardiac catheterization laboratory;
(c) A radiation therapy facility; or
(d) An independent diagnostic laboratory whose primary business is providing diagnostic imaging services to the public at which at least three (3) of the following are performed:
(1)Magnetic resonance imaging;
(2)CAT scan;
(3)Nuclear medicine;
(4)Ultrasound;
(5)X-ray; or
(6)Mammography.