Current through Register Vol. 54, No. 44, November 2, 2024
Section 301.10 - Continuing effect of determinations(a) Except in the case of a long-term construction plan of the type described in subsection (b), where the designated planning agency has found that a proposed capital expenditure is in conformity with the standards, criteria and plans described in § 301.4(a)(2) (relating to designation; review of proposed capital expenditures), the obligation for capital expenditure shall be incurred not more than 1 year following the date of the finding; provided, that the designated planning agency may, under a showing of good cause by the person proposing the expenditure, extend the period during which the obligation shall be incurred for up to an additional 6 months from the expiration date of the original approval. The health systems agency shall contact the applicant no later than 10 months after the designated planning agency approval to notify the person of the expiration date and of the procedure for requesting a 6-month extension for good cause. If no obligation is incurred within the period or, if incurred, the facility or organization has not started construction or purchased the equipment for which the approval was granted, within 6 months following the expiration date for incurring an obligation, the approval of the designated planning agency shall, for purposes of this chapter, be deemed to be terminated upon the expiration of the applicable period. When a project approval is terminated for failure to incur an obligation or to start construction or purchase equipment in a timely manner, the designated planning agency will notify the applicant in writing of the termination.(b) In the case of a plan for capital expenditures proposed by or on behalf of a health care facility or health maintenance organization under which a series of obligations for capital expenditures for discrete components of the plan is to be incurred over a period longer than 1 year, the designated planning agency may review and approve or disapprove, for purposes of this chapter, those of capital expenditures which it estimates will be incurred within 3 years following the date of approval or disapproval.(c) Problems shall be dealt with as follows: (1) In any case in which the Secretary of HHS has determined under a finding by the designated planning agency that a proposed capital expenditure is not in conformity with the standards, criteria or plans described in § 301.4(a)(2), that expenses related to the capital expenditure will not be included in determining Federal payments under Titles V, XVIII and XIX of the act (42 U.S.C.A. §§ 701-709, 1395-1395zz and 1396-1396ff), the health care facility or health maintenance organization to whom the payments are made shall be entitled, upon its request to the designated planning agency in such form and manner and supported by information as the agency may require, to a reconsideration by the designated planning agency of the finding: (i) Whenever there is a substantial change in existing or proposed health facilities or services of the type proposed in the area served by the facility or organization.(ii) Upon a substantial change in the need for facilities or services of the type proposed in the area served by the facility or organization as reflected in the standards, criteria or plans referred to in § 301.4(a)(2).(iii) At any time following the expiration of 3 years from the date of the finding of the designated planning agency or of its last reconsideration of a finding under this subsection, whichever is later.(2) Reconsideration shall be dealt with as follows: (i) If, upon reconsideration of its finding under this subsection and after consulting with and taking into consideration the findings and recommendations of the other agency described in § 301.4(a)(2)(i) the designated planning agency finds that the facilities or services provided by the capital expenditure are in conformity with the standards, criteria and plans described in § 301.4(a)(2) it shall promptly so notify the Secretary of HHS and the person submitting the request.(ii) If the designated planning agency, upon reconsideration, reaffirms its previous finding, the procedure set forth in § 301.6 (relating to procedures for agency review) and fair hearings following an initial determination shall be followed.(3) Upon notification by a designated planning agency of a revised finding in accordance with paragraph (2), the Secretary of HHS will include (42 U.S.C.A. §§ 701-709, 1395-1395zz and 1396-1396ff), in determining future payments under Titles V, XVIII and XIX of the act, expenses related to the capital expenditure. The expenses will be included for periods following the date of notification only and amounts previously excluded may not be taken into account in determining Federal payments under Titles V, XVIII and XIX of the act.