West Virginia Health Care Authority

Rate Review

Subsequent to the passage of SB 68, the Health Care Authority’s ability to establish hospital rates ceased on July 1, 2016.

However, it is important that all hospitals continue to submit quarterly compliance reports
(CBM-9 or B-9) for each quarter covered by the FY 2016 rate order. SB 68 did not rescind the orders in place; therefore, hospitals must comply with the rates established in the FY 2016 rate orders.

Although, the Health Care Authority may no longer reduce a hospital’s rates for failure to comply with its rate order, there are other sanctions which remain in effect. These include a determination that a certificate of need is not complete or that the certificate of need application or request for exemption warrants denial for failure to file the required compliance reports. The law further permits the board to impose fines for failure to comply with the Authority’s statutes and rules.

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