State Codes and Statutes

State Codes and Statutes

Statutes > North-carolina > Chapter_131E > GS_131E-192_4

§ 131E‑192.4. Procedure for review; standards for review.

(a)        The Department shall review an application in accordancewith the standards set forth in subsection (b) of this section and shall hold apublic hearing with the opportunity for the submission of oral and writtenpublic comments in accordance with rules adopted by the Department.  TheDepartment shall determine whether the application should be granted or deniedwithin 90 days of the date the application is filed.  The Department may extendthe review period for a specified period of time upon notice to the parties.

(b)        The Department shall determine that a certificate of publicadvantage should be issued for a cooperative agreement if it determines that anapplicant has demonstrated by clear and convincing evidence that the benefitslikely to result from the agreement outweigh the disadvantages likely to resultfrom a reduction in competition from the agreement.

(1)        In evaluating the potential benefits of a cooperativeagreement, the Department shall consider whether one or more of the followingbenefits may result from the cooperative agreement:

a.         Enhancement of the quality of hospital and hospital‑relatedcare provided to North Carolina citizens.

b.         Preservation of hospital facilities in geographicalproximity to the communities traditionally served by those facilities.

c.         Lower costs of, or gains in, the efficiency of deliveringhospital services.

d.         Improvements in the utilization of hospital resources andequipment.

e.         Avoidance of duplication of hospital resources.

f.          The extent to which medically underserved populations areexpected to utilize the proposed services.

(2)        In evaluating the potential disadvantages of a cooperativeagreement, the Department shall consider whether one or more of the followingdisadvantages may result from the cooperative agreements:

a.         The extent to which the agreement may increase the costs orprices of health care at a hospital which is party to the cooperativeagreement.

b.         The extent to which the agreement may have an adverse impacton patients in the quality, availability, and price of health care services.

c.         The extent to which the agreement may reduce competitionamong the parties to the agreement and the likely effects thereof.

d.         The extent to which the agreement may have an adverse impacton the ability of health maintenance organizations, preferred providerorganizations, managed health care service agents, or other health care payorsto negotiate optimal payment and service arrangements with hospitals, physicians,allied health care professionals, or other health care providers.

e.         The extent to which the agreement may result in a reductionin competition among physicians, allied health professionals, other health careproviders, or other persons furnishing goods or services to, or in competitionwith, hospitals.

f.          The availability of arrangements that are less restrictiveto competition and achieve the same benefits or a more favorable balance ofbenefits over disadvantages attributable to any reduction in competition.

(3)        In making its determination, the Department may considerother benefits or disadvantages that may be identified. (1993, c. 529, s. 5.2; 1997‑456, s. 27.)