August 7, 2019

 Ms. Mylam Ly

Policy Analyst

Virginia Department of Health

Richmond, VA 23219

Email: Mylam.ly@vdh.virginia.gov

 Re:      Virginia Regulatory Town Hall concerning regulations 12 VAC 5-215, 12 VAC 5-216, 12 VAC 5-217, and 12 VAC 5-218, Notice of periodic Review Posted 6/9/2019.

 Dear Ms. Ly:

 On behalf of the Virginia Hospital & Healthcare Association’s (VHHA) 29 member health systems, representing 110 community, psychiatric, rehabilitation, and specialty hospitals, thank you for the opportunity to comment on the periodic review of regulations affecting the Virginia Department of Health and multiple regulations affecting data reporting.

Chapters 215 and 216 of the Department of Health regulatory provisions should be repealed as they are unnecessary and no longer in use.  Virginia Health Information has made substantial changes to the filing requirements and the data elements which are filed, and these regulations should be updated to reflect such changes.  Specifically, 12 VAC 5-215-50 through 215-210 have been changed significantly due to different filing requirements and the means utilized to submit such information. It appears that chapter 216 can be repealed entirely with the appropriate modifications to chapter 215. 

12 VAC 5-217 appears to be utilizing an outdated record layout which should be updated to the layout that has been used for several years. 

For 12 VAC 5-218, we would like to propose several modifications and additions in order that this chapter matches up more closely with chapter 217, which pertains to inpatient data.  Since the establishment of these regulations, the place of service for patients has moved from the inpatient setting with a substantial and growing  volume being performed on an outpatient basis.  Accordingly, it is in the best interest of the Commonwealth to expand the data being collected in the outpatient setting, and the regulations should be adjusted to allow the ability to capture this information. 

In 12 VAC 5-218-10, the last sentence in the definition of “outpatient surgical procedures” which references a pilot study should be deleted.

Two sections need to be added to chapter 218 so that the outpatient filing matches that of the inpatient filing.  Sections 217-70 and 217-100 should be added to chapter 218 in order to allow VDH the opportunity to collect more robust outpatient data. The potential language would read:

12VAC5-218-70. Establishment of Annual Fee.

The board shall not assess any fee against any health care provider that submits data under this chapter that is processed, verified, and timely in accordance with standards established by the board. The board shall prescribe a reasonable fee not to exceed $1.00 per discharge for each outpatient provider submitting patient-level data pursuant to this chapter that is not processed, verified, or timely to cover the cost of the reasonable expenses in processing and verifying such data. The fee shall be established and reviewed annually by the board.

12VAC5-218-100. Late Charge.

A late charge of $25 per working day shall be paid to the board by an outpatient provider that does not submit, in aggregate, a complete filing of the patient-level data required by 12VAC5-218-20 for all outpatient procedures in a calendar year quarter pursuant to the times established in 12VAC5-218-60. This requirement may be waived by the board if a provider can show that an extenuating circumstance exists. Examples of an extenuating circumstance include, but are not limited to, the installation of a new computerized billing system, a bankruptcy proceeding, closure of the institution, change of ownership in the institution, or the institution is a new facility that has recently opened.

Thank you for the opportunity to comment on these notices posted on June 9, 2019.

Should you have any questions or require any additional information regarding our comments please do not hesitate to contact me at jandrews@vhha.com, 804-965-1229 at your convenience. 

Sincerely,

/s/

James B. Andrews III

Vice President, Financial Policy