W. Va. Code R. § 65-26-13

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 65-26-13 - Interim Order

13.1. If a hearing is requested on the hospital's rate application by an affected party, which is not the applicant or the Authority, and the request for hearing is not later withdrawn by the affected party, the hospital may, within fifteen (15) days of receipt of the hearing request, request the Authority to establish an interim rate pending the final order of the Authority.

13.2. The interim rate shall be calculated by the Authority from the information contained in the pending application. The Authority shall review any overage which the hospital may have at the time of the filing of the rate application and consider the amount of the overage in determining the interim rate.

13.3. The Authority shall approve or deny an interim rate for the hospital within thirty (30) days after the receipt of the request for an interim rate by the hospital. The interim rate shall remain in effect for six (6) months from the effective date of the interim order or until the effective date of a final order, whichever first occurs. If a final order is not entered within six (6) months from the effective date of the interim rate, the interim rate expires at the conclusion of the six (6) month period and the hospital shall implement the rates which were last approved by the Authority by a final order.

13.4. The Authority may rescind the interim rate during the six (6) month period if it finds that the hospital made material misrepresentations to the Authority; that the application and/or interim rate request is based upon inaccurate data; or that other good cause exists for rescission.

13.5. If the Authority approves an interim rate increase for the hospital, the Authority may order the hospital to keep a detailed and accurate account of all amounts received by reason of the increase in rates and the purchasers and third-party payors from whom the amounts were received. The Authority may order the hospital to refund with interest to each affected purchaser and/or third-party payor any part of the increase in rates that may be held to be excessive or unreasonable. In the event a refund is not practicable, the hospital shall, under appropriate terms and conditions determined by the board, temporarily decrease its rates by an amount equal to the income realized from that portion of the increase in rates which was subsequently held to be excessive or unreasonable.

13.6. If the final order subsequently entered by the Authority establishes revenue limits for the hospital which are greater than the interim revenue limits, the hospital shall not increase its rates in excess of the limits approved by the final order.

13.7. The interim rate request is discretionary with the hospital and the interim order issued by the Authority is not a final or appealable order pursuant to W.Va. Code § 16-29B-13.

W. Va. Code R. § 65-26-13