Current through Register Vol. XLI, No. 50, December 13, 2024
Section 65-22-3 - DefinitionsAs used in this rule, all terms have the same meaning as provided in section two of the Act. Terms not defined in the Act have the following meanings except where the context may expressly require otherwise.
3.1. "Authority" means the West Virginia Health Care Cost Review Authority, an autonomous division of the West Virginia Department of Health and Human Services.3.2. "Act" means the West Virginia Health Care Cost Review Authority Act, W. Va. Code '16-29B-1 et seq.3.3. "Interested party" means any individual, group or organization which files a written request with the Authority on or before the prehearing conference stating that the individual, group or organization is aggrieved or is likely to be aggrieved based upon information and belief by any act or failure to act by the Authority or by any rule, regulation or final order of the Authority and setting forth with particularity the basis for the request.3.4. "Affected party" means any interested party which is recognized by the Authority as an affected party.3.5. "Code" means the Code of West Virginia of 1931, as amended.3.6. "Border hospital" means a hospital located in the State of West Virginia which is located within ten (10) miles of an out-of-state hospital having a similar number of beds and a similar array of services as the West Virginia hospital.3.7. "Discount contract" means any contract for the payment of patient care services between a purchaser or third party payor and a hospital which establishes discounts to the purchaser or third party payor and which is subject to the approval of the Authority pursuant to W. Va. Code '16-29-20. Examples of discount contracts include, but are not limited to, (1) written contracts between a hospital and a third party payor or purchaser establishing a discount to the payor or purchaser in the form of a percentage reduction in the amount of charges, (2) other adjustments that have the effect of decreasing the amount of charges and (3) informal arrangements between hospitals and purchasers or third party payors which have the effect of decreasing the amount of charges for a group of patients.3.8. "Verified notice" means a notice which contains all of the facts and information required by this rule and which has attached to it a statement made under oath before a notary public or other official entitled to administer oaths in West Virginia by the chief executive officer of the border hospital that the facts and circumstances set forth in the notice are true, accurate and complete to the best knowledge of the chief executive officer.