§ 90-21.27. Procedure for review; standards for review. - North Carolina Statutes

§ 90‑21.27. Procedure for review; standards for review.

(a)        The Department shall review the 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 of filing of an application. Provided, however, thatthe Department may extend the review period for a specified period of time uponnotice to the parties.

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

(1)        In evaluating the potential benefits of a cooperative agreement,the Department shall consider whether one or more of the following benefits mayresult from the cooperative agreement:

a.         Enhancement of the quality of health care provided to NorthCarolina citizens;

b.         Preservation of other health care facilities in geographicalproximity to the communities traditionally served by those facilities;

c.         Lower costs of, or gains in the efficiency of delivering,health care services;

d.         Improvements in the utilization of health care resources andequipment;

e.         Avoidance of duplication of health care resources; and

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 agreement:

a.         The extent to which the agreement may increase the costs orprices of health care at the locations of parties to the cooperative agreement;

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 health care services; and

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. (1995, c. 395, s. 2; 1997‑456, s. 27.)