(a) The Department shall review an application in accordance with the standards set forth in subsection (b) of this section and shall hold a public hearing with the opportunity for the submission of oral and written public comments in accordance with rules adopted by the Department. The Department shall determine whether the application should be granted or denied within 90 days of the date the application is filed. The Department may extend the review period for a specified period of time upon notice to the parties.
(b) The Department shall determine that a certificate of public advantage should be issued for a cooperative agreement if it determines that an applicant has demonstrated by clear and convincing evidence that the benefits likely to result from the agreement outweigh the disadvantages likely to 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 may result from the cooperative agreement:
a. Enhancement of the quality of hospital and hospital-related care provided to North Carolina citizens.
b. Preservation of hospital facilities in geographical proximity to the communities traditionally served by those facilities.
c. Lower costs of, or gains in, the efficiency of delivering hospital services.
d. Improvements in the utilization of hospital resources and equipment.
e. Avoidance of duplication of hospital resources.
f. The extent to which medically underserved populations are expected to utilize the proposed services.
(2) In evaluating the potential disadvantages of a cooperative agreement, the Department shall consider whether one or more of the following disadvantages may result from the cooperative agreements:
a. The extent to which the agreement may increase the costs or prices of health care at a hospital which is party to the cooperative agreement.
b. The extent to which the agreement may have an adverse impact on patients in the quality, availability, and price of health care services.
c. The extent to which the agreement may reduce competition among the parties to the agreement and the likely effects thereof.
d. The extent to which the agreement may have an adverse impact on the ability of health maintenance organizations, preferred provider organizations, managed health care service agents, or other health care payors to 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 reduction in competition among physicians, allied health professionals, other health care providers, or other persons furnishing goods or services to, or in competition with, hospitals.
f. The availability of arrangements that are less restrictive to competition and achieve the same benefits or a more favorable balance of benefits over disadvantages attributable to any reduction in competition.
(3) In making its determination, the Department may consider other benefits or disadvantages that may be identified. (1993, c. 529, s. 5.2; 1997-456, s. 27.)
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Last modified: March 23, 2014