CON; revise certain provisions of., the official text

MISSISSIPPI LEGISLATURE

2026 Regular Session

To: Public Health and Human Services; State Affairs

By: Representatives Creekmore IV, Felsher

House Bill 3

(As Sent to Governor)

AN ACT TO AMEND SECTION 41-7-191, MISSISSIPPI CODE OF 1972,
TO REVISE CERTAIN PROVISIONS RELATING TO A HOSPITAL THAT HAS A CERTIFICATE OF
NEED FOR A FORTY-BED PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY IN DESOTO
COUNTY; TO PROVIDE THAT THERE SHALL BE NO PROHIBITION OR RESTRICTIONS ON
PARTICIPATION IN THE MEDICAID PROGRAM FOR SUCH FACILITY THAT WOULD NOT
OTHERWISE APPLY TO ANY OTHER SUCH FACILITY; TO REQUIRE THE ISSUANCE OF A
CERTIFICATE OF NEED FOR ADDITIONAL BEDS IN A COMMUNITY LIVING PROGRAM FOR
DEVELOPMENTALLY DISABLED ADULTS LOCATED IN MADISON COUNTY; TO REVISE THE
CONDITIONS FOR A CERTIFICATE OF NEED ISSUED FOR A LONG-TERM CARE HOSPITAL IN
HARRISON COUNTY TO ALLOW THE HOSPITAL TO PARTICIPATE IN THE MEDICAID PROGRAM AS
A CROSSOVER PROVIDER; TO PROVIDE THAT THE UNIVERSITY OF MISSISSIPPI MEDICAL
CENTER NEED NOT OBTAIN A CERTIFICATE OF NEED FOR ANY HOSPITAL BEDS, SERVICES,
HEALTH CARE FACILITIES, OR MEDICAL EQUIPMENT THAT HAVE BEEN APPROVED AND
CONTINUOUSLY OPERATED UNDER A CERTIFICATE OF NEED EXEMPTION FOR A TEACHING
HOSPITAL, OR THAT ARE APPROVED OR APPLIED FOR BEFORE THE EFFECTIVE DATE
OF THIS ACT, RELOCATION; TO PROVIDE THAT FROM AND AFTER THE EFFECTIVE DATE OF
THIS ACT, THE UNIVERSITY OF MISSISSIPPI MEDICAL CENTER SHALL HAVE AN ACADEMIC
EXEMPTION FROM THE CERTIFICATE OF NEED REQUIREMENTS ONLY WITHIN A CERTAIN AREA
OF JACKSON, MISSISSIPPI; TO CLARIFY THAT IN ORDER FOR THE UNIVERSITY OF
MISSISSIPPI MEDICAL CENTER TO QUALIFY FOR SUCH AN ACADEMIC EXEMPTION, THE STATE
HEALTH OFFICER MUST DETERMINE THAT THE PROPOSED EQUIPMENT OR FACILITY FULFILLS
A SUBSTANTIAL AND MEANINGFUL ACADEMIC FUNCTION; TO DIRECT THE STATE DEPARTMENT
OF HEALTH TO CONDUCT A STUDY AND REPORT BY DECEMBER 1, 2026, ON THE FEASIBILITY
OF EXEMPTING SMALL HOSPITALS FROM THE REQUIREMENT FOR A CERTIFICATE OF NEED FOR
THE PLACEMENT OF DIALYSIS UNITS TO REDUCE THE NUMBER OF TRANSFERS FOR PATIENTS
REQUIRING DIALYSIS, THE FEASIBILITY OF EXEMPTING SMALL HOSPITALS FROM THE
REQUIREMENT FOR A CERTIFICATE OF NEED TO OPERATE GERIATRIC PSYCHIATRIC UNITS,
AND THE FEASIBILITY OF A NEW REQUIREMENT THAT ACUTE ADULT PSYCHIATRIC UNITS
TREAT A CERTAIN PERCENTAGE OF UNINSURED PATIENTS OR PAY A PERIODIC FEE IN LIEU
THEREOF; TO AMEND SECTION 41-7-173, MISSISSIPPI CODE OF 1972, TO INCREASE THE
MINIMUM DOLLAR AMOUNTS OF CAPITAL EXPENDITURES AND MAJOR MEDICAL EQUIPMENT THAT
REQUIRE THE ISSUANCE OF A CERTIFICATE OF NEED; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE
LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1.  Section
41-7-191, Mississippi Code of 1972, is amended as follows:

41-7-191.  (1)  No person
shall engage in any of the following activities without obtaining the required
certificate of need:

(a)  The construction,
development or other establishment of a new health care facility, which
establishment shall include the reopening of a health care facility that has
ceased to operate for a period of sixty (60) months or more;

(b)  The relocation of
a health care facility or portion thereof, or major medical equipment, unless
such relocation of a health care facility or portion thereof, or major medical
equipment, which does not involve a capital expenditure by or on behalf of a
health care facility, is within five thousand two hundred eighty (5,280) feet
from the main entrance of the health care facility;

(c)  Any change in the
existing bed complement of any health care facility through the addition or
conversion of any beds or the alteration, modernizing or refurbishing of any
unit or department in which the beds may be located; however, if a health care
facility has voluntarily delicensed some of its existing bed complement, it may
later relicense some or all of its delicensed beds without the necessity of
having to acquire a certificate of need.  The State Department of Health shall
maintain a record of the delicensing health care facility and its voluntarily
delicensed beds and continue counting those beds as part of the state's total
bed count for health care planning purposes.  If a health care facility that
has voluntarily delicensed some of its beds later desires to relicense some or
all of its voluntarily delicensed beds, it shall notify the State Department of
Health of its intent to increase the number of its licensed beds.  The State
Department of Health shall survey the health care facility within thirty (30)
days of that notice and, if appropriate, issue the health care facility a new
license reflecting the new contingent of beds.  However, in no event may a
health care facility that has voluntarily delicensed some of its beds be
reissued a license to operate beds in excess of its bed count before the
voluntary delicensure of some of its beds without seeking certificate of need
approval;

(d)  Offering of the
following health services if those services have not been provided on a regular
basis by the proposed provider of such services within the period of twelve
(12) months prior to the time such services would be offered:

(i)  Open-heart
surgery services;

(ii)  Cardiac
catheterization services;

(iii)
Comprehensive inpatient rehabilitation services;

(iv)  Licensed
psychiatric services;

(v)  Licensed
chemical dependency services;

(vi)  Radiation
therapy services;

(vii)  Diagnostic
imaging services of an invasive nature, i.e. invasive digital angiography;

(viii)  Nursing
home care as defined in subparagraphs (iv), (vi) and (viii) of Section 41-7-173(h);

(ix)  Home health
services;

(x)  Swing-bed
services;

(xi)  Ambulatory
surgical services;

(xii)  Magnetic
resonance imaging services;

(xiii)  [Deleted]

(xiv)  Long-term
care hospital services;

(xv)  Positron
emission tomography (PET) services;

(e)  The relocation of
one or more health services from one physical facility or site to another
physical facility or site, unless such relocation, which does not involve a
capital expenditure by or on behalf of a health care facility, (i) is to a
physical facility or site within five thousand two hundred eighty (5,280) feet
from the main entrance of the health care facility where the health care
service is located, or (ii) is the result of an order of a court of appropriate
jurisdiction or a result of pending litigation in such court, or by order of
the State Department of Health, or by order of any other agency or legal entity
of the state, the federal government, or any political subdivision of either,
whose order is also approved by the State Department of Health;

(f)  The acquisition or
otherwise control of any major medical equipment for the provision of medical
services; however, (i) the acquisition of any major medical equipment used only
for research purposes, and (ii) the acquisition of major medical equipment to
replace medical equipment for which a facility is already providing medical
services and for which the State Department of Health has been notified before
the date of such acquisition shall be exempt from this paragraph; an
acquisition for less than fair market value must be reviewed, if the
acquisition at fair market value would be subject to review;

(g)  Changes of
ownership of existing health care facilities in which a notice of intent is not
filed with the State Department of Health at least thirty (30) days prior to
the date such change of ownership occurs, or a change in services or bed
capacity as prescribed in paragraph (c) or (d) of this subsection as a result
of the change of ownership; an acquisition for less than fair market value must
be reviewed, if the acquisition at fair market value would be subject to
review;

(h)  The change of
ownership of any health care facility defined in subparagraphs (iv), (vi) and
(viii) of Section 41-7-173(h), in which a notice of intent as described in
paragraph (g) has not been filed and if the Executive Director, Division of
Medicaid, Office of the Governor, has not certified in writing that there will
be no increase in allowable costs to Medicaid from revaluation of the assets or
from increased interest and depreciation as a result of the proposed change of
ownership;

(i)  Any activity
described in paragraphs (a) through (h) if undertaken by any person if that
same activity would require certificate of need approval if undertaken by a
health care facility;

(j)  Any capital
expenditure or deferred capital expenditure by or on behalf of a health care
facility not covered by paragraphs (a) through (h);

(k)  The contracting of
a health care facility as defined in subparagraphs (i) through (viii) of
Section 41-7-173(h) to establish a home office, subunit, or branch office in
the space operated as a health care facility through a formal arrangement with
an existing health care facility as defined in subparagraph (ix) of Section 41-7-173(h);

(l)  The replacement or
relocation of a health care facility designated as a critical access hospital
shall be exempt from subsection (1) of this section so long as the critical
access hospital complies with all applicable federal law and regulations regarding
such replacement or relocation;

(m)  Reopening a health
care facility that has ceased to operate for a period of sixty (60) months or
more, which reopening requires a certificate of need for the establishment of a
new health care facility.

(2)  The State Department of
Health shall not grant approval for or issue a certificate of need to any
person proposing the new construction of, addition to, or expansion of any
health care facility defined in subparagraphs (iv) (skilled nursing facility)
and (vi) (intermediate care facility) of Section 41-7-173(h) or the conversion
of vacant hospital beds to provide skilled or intermediate nursing home care,
except as hereinafter authorized:

(a)  The department may
issue a certificate of need to any person proposing the new construction of any
health care facility defined in subparagraphs (iv) and (vi) of Section 41-7-173(h)
as part of a life care retirement facility, in any county bordering on the Gulf
of Mexico in which is located a National Aeronautics and Space Administration
facility, not to exceed forty (40) beds.  From and after July 1, 1999, there
shall be no prohibition or restrictions on participation in the Medicaid
program (Section 43-13-101 et seq.) for the beds in the health care facility
that were authorized under this paragraph (a).

(b)  The department may
issue certificates of need in Harrison County to provide skilled nursing home
care for Alzheimer's disease patients and other patients, not to exceed one
hundred fifty (150) beds.  From and after July 1, 1999, there shall be no prohibition
or restrictions on participation in the Medicaid program (Section 43-13-101 et
seq.) for the beds in the nursing facilities that were authorized under this
paragraph (b).

(c)  The department may
issue a certificate of need for the addition to or expansion of any skilled
nursing facility that is part of an existing continuing care retirement
community located in Madison County, provided that the recipient of the
certificate of need agrees in writing that the skilled nursing facility will
not at any time participate in the Medicaid program (Section 43-13-101 et seq.)
or admit or keep any patients in the skilled nursing facility who are
participating in the Medicaid program.  This written agreement by the recipient
of the certificate of need shall be fully binding on any subsequent owner of
the skilled nursing facility, if the ownership of the facility is transferred
at any time after the issuance of the certificate of need.  Agreement that the
skilled nursing facility will not participate in the Medicaid program shall be
a condition of the issuance of a certificate of need to any person under this
paragraph (c), and if such skilled nursing facility at any time after the
issuance of the certificate of need, regardless of the ownership of the
facility, participates in the Medicaid program or admits or keeps any patients
in the facility who are participating in the Medicaid program, the State
Department of Health shall revoke the certificate of need, if it is still
outstanding, and shall deny or revoke the license of the skilled nursing
facility, at the time that the department determines, after a hearing complying
with due process, that the facility has failed to comply with any of the
conditions upon which the certificate of need was issued, as provided in this
paragraph and in the written agreement by the recipient of the certificate of
need.  The total number of beds that may be authorized under the authority of
this paragraph (c) shall not exceed sixty (60) beds.

(d)  The State
Department of Health may issue a certificate of need to any hospital located in
DeSoto County for the new construction of a skilled nursing facility, not to
exceed one hundred twenty (120) beds, in DeSoto County.  From and after July 1,
1999, there shall be no prohibition or restrictions on participation in the
Medicaid program (Section 43-13-101 et seq.) for the beds in the nursing
facility that were authorized under this paragraph (d).

(e)  The State
Department of Health may issue a certificate of need for the construction of a
nursing facility or the conversion of beds to nursing facility beds at a
personal care facility for the elderly in Lowndes County that is owned and
operated by a Mississippi nonprofit corporation, not to exceed sixty (60)
beds.  From and after July 1, 1999, there shall be no prohibition or
restrictions on participation in the Medicaid program (Section 43-13-101 et
seq.) for the beds in the nursing facility that were authorized under this
paragraph (e).

(f)  The State
Department of Health may issue a certificate of need for conversion of a county
hospital facility in Itawamba County to a nursing facility, not to exceed sixty
(60) beds, including any necessary construction, renovation or expansion.  From
and after July 1, 1999, there shall be no prohibition or restrictions on
participation in the Medicaid program (Section 43-13-101 et seq.) for the beds
in the nursing facility that were authorized under this paragraph (f).

(g)  The State
Department of Health may issue a certificate of need for the construction or
expansion of nursing facility beds or the conversion of other beds to nursing
facility beds in either Hinds, Madison or Rankin County, not to exceed sixty
(60) beds.  From and after July 1, 1999, there shall be no prohibition or
restrictions on participation in the Medicaid program (Section 43-13-101 et
seq.) for the beds in the nursing facility that were authorized under this
paragraph (g).

(h)  The State
Department of Health may issue a certificate of need for the construction or
expansion of nursing facility beds or the conversion of other beds to nursing
facility beds in either Hancock, Harrison or Jackson County, not to exceed
sixty (60) beds.  From and after July 1, 1999, there shall be no prohibition or
restrictions on participation in the Medicaid program (Section 43-13-101 et
seq.) for the beds in the facility that were authorized under this paragraph
(h).

(i)  The department may
issue a certificate of need for the new construction of a skilled nursing
facility in Leake County, provided that the recipient of the certificate of
need agrees in writing that the skilled nursing facility will not at any time
participate in the Medicaid program (Section 43-13-101 et seq.) or admit or
keep any patients in the skilled nursing facility who are participating in the
Medicaid program.  This written agreement by the recipient of the certificate
of need shall be fully binding on any subsequent owner of the skilled nursing
facility, if the ownership of the facility is transferred at any time after the
issuance of the certificate of need.  Agreement that the skilled nursing
facility will not participate in the Medicaid program shall be a condition of
the issuance of a certificate of need to any person under this paragraph (i),
and if such skilled nursing facility at any time after the issuance of the
certificate of need, regardless of the ownership of the facility, participates
in the Medicaid program or admits or keeps any patients in the facility who are
participating in the Medicaid program, the State Department of Health shall
revoke the certificate of need, if it is still outstanding, and shall deny or
revoke the license of the skilled nursing facility, at the time that the
department determines, after a hearing complying with due process, that the
facility has failed to comply with any of the conditions upon which the
certificate of need was issued, as provided in this paragraph and in the
written agreement by the recipient of the certificate of need.  The provision
of Section 41-7-193(1) regarding substantial compliance of the projection of
need as reported in the current State Health Plan is waived for the purposes of
this paragraph.  The total number of nursing facility beds that may be
authorized by any certificate of need issued under this paragraph (i) shall not
exceed sixty (60) beds.  If the skilled nursing facility authorized by the
certificate of need issued under this paragraph is not constructed and fully
operational within eighteen (18) months after July 1, 1994, the State
Department of Health, after a hearing complying with due process, shall revoke
the certificate of need, if it is still outstanding, and shall not issue a
license for the skilled nursing facility at any time after the expiration of
the eighteen-month period.

(j)  The department may
issue certificates of need to allow any existing freestanding long-term care
facility in Tishomingo County and Hancock County that on July 1, 1995, is
licensed with fewer than sixty (60) beds.  For the purposes of this
paragraph (j), the provisions of Section 41-7-193(1) requiring substantial
compliance with the projection of need as reported in the current State Health
Plan are waived.  From and after July 1, 1999, there shall be no prohibition or
restrictions on participation in the Medicaid program (Section 43-13-101 et
seq.) for the beds in the long-term care facilities that were authorized under
this paragraph (j).

(k)  The department may
issue a certificate of need for the construction of a nursing facility at a
continuing care retirement community in Lowndes County.  The total number of
beds that may be authorized under the authority of this paragraph (k) shall not
exceed sixty (60) beds.  From and after July 1, 2001, the prohibition on the
facility participating in the Medicaid program (Section 43-13-101 et seq.) that
was a condition of issuance of the certificate of need under this paragraph (k)
shall be revised as follows:  The nursing facility may participate in the
Medicaid program from and after July 1, 2001, if the owner of the facility on
July 1, 2001, agrees in writing that no more than thirty (30) of the beds at
the facility will be certified for participation in the Medicaid program, and
that no claim will be submitted for Medicaid reimbursement for more than thirty
(30) patients in the facility in any month or for any patient in the facility
who is in a bed that is not Medicaid-certified.  This written agreement by the
owner of the facility shall be a condition of licensure of the facility, and
the agreement shall be fully binding on any subsequent owner of the facility if
the ownership of the facility is transferred at any time after July 1, 2001.
After this written agreement is executed, the Division of Medicaid and the
State Department of Health shall not certify more than thirty (30) of the beds
in the facility for participation in the Medicaid program.  If the facility violates
the terms of the written agreement by admitting or keeping in the facility on a
regular or continuing basis more than thirty (30) patients who are
participating in the Medicaid program, the State Department of Health shall
revoke the license of the facility, at the time that the department determines,
after a hearing complying with due process, that the facility has violated the
written agreement.

(l)  Provided that
funds are specifically appropriated therefor by the Legislature, the department
may issue a certificate of need to a rehabilitation hospital in Hinds County
for the construction of a sixty-bed long-term care nursing facility dedicated
to the care and treatment of persons with severe disabilities including persons
with spinal cord and closed-head injuries and ventilator dependent patients.
The provisions of Section 41-7-193(1) regarding substantial compliance with
projection of need as reported in the current State Health Plan are waived for
the purpose of this paragraph.

(m)  The State
Department of Health may issue a certificate of need to a county-owned hospital
in the Second Judicial District of Panola County for the conversion of not more
than seventy-two (72) hospital beds to nursing facility beds, provided that the
recipient of the certificate of need agrees in writing that none of the beds at
the nursing facility will be certified for participation in the Medicaid
program (Section 43-13-101 et seq.), and that no claim will be submitted for
Medicaid reimbursement in the nursing facility in any day or for any patient in
the nursing facility.  This written agreement by the recipient of the
certificate of need shall be a condition of the issuance of the certificate of
need under this paragraph, and the agreement shall be fully binding on any
subsequent owner of the nursing facility if the ownership of the nursing
facility is transferred at any time after the issuance of the certificate of need.
After this written agreement is executed, the Division of Medicaid and the
State Department of Health shall not certify any of the beds in the nursing
facility for participation in the Medicaid program.  If the nursing facility
violates the terms of the written agreement by admitting or keeping in the
nursing facility on a regular or continuing basis any patients who are
participating in the Medicaid program, the State Department of Health shall
revoke the license of the nursing facility, at the time that the department
determines, after a hearing complying with due process, that the nursing
facility has violated the condition upon which the certificate of need was
issued, as provided in this paragraph and in the written agreement.  If the
certificate of need authorized under this paragraph is not issued within twelve
(12) months after July 1, 2001, the department shall deny the application for
the certificate of need and shall not issue the certificate of need at any time
after the twelve-month period, unless the issuance is contested.  If the
certificate of need is issued and substantial construction of the nursing
facility beds has not commenced within eighteen (18) months after July 1, 2001,
the State Department of Health, after a hearing complying with due process,
shall revoke the certificate of need if it is still outstanding, and the
department shall not issue a license for the nursing facility at any time after
the eighteen-month period.  However, if the issuance of the certificate of need
is contested, the department shall require substantial construction of the
nursing facility beds within six (6) months after final adjudication on the
issuance of the certificate of need.

(n)  The department may
issue a certificate of need for the new construction, addition or conversion of
skilled nursing facility beds in Madison County, provided that the recipient of
the certificate of need agrees in writing that the skilled nursing facility
will not at any time participate in the Medicaid program (Section 43-13-101 et
seq.) or admit or keep any patients in the skilled nursing facility who are
participating in the Medicaid program.  This written agreement by the recipient
of the certificate of need shall be fully binding on any subsequent owner of
the skilled nursing facility, if the ownership of the facility is transferred
at any time after the issuance of the certificate of need.  Agreement that the
skilled nursing facility will not participate in the Medicaid program shall be
a condition of the issuance of a certificate of need to any person under this
paragraph (n), and if such skilled nursing facility at any time after the
issuance of the certificate of need, regardless of the ownership of the
facility, participates in the Medicaid program or admits or keeps any patients
in the facility who are participating in the Medicaid program, the State
Department of Health shall revoke the certificate of need, if it is still
outstanding, and shall deny or revoke the license of the skilled nursing
facility, at the time that the department determines, after a hearing complying
with due process, that the facility has failed to comply with any of the
conditions upon which the certificate of need was issued, as provided in this
paragraph and in the written agreement by the recipient of the certificate of
need.  The total number of nursing facility beds that may be authorized by any
certificate of need issued under this paragraph (n) shall not exceed sixty (60)
beds.  If the certificate of need authorized under this paragraph is not issued
within twelve (12) months after July 1, 1998, the department shall deny the
application for the certificate of need and shall not issue the certificate of
need at any time after the twelve-month period, unless the issuance is
contested.  If the certificate of need is issued and substantial construction
of the nursing facility beds has not commenced within eighteen (18) months
after July 1, 1998, the State Department of Health, after a hearing complying
with due process, shall revoke the certificate of need if it is still
outstanding, and the department shall not issue a license for the nursing
facility at any time after the eighteen-month period.  However, if the issuance
of the certificate of need is contested, the department shall require
substantial construction of the nursing facility beds within six (6) months
after final adjudication on the issuance of the certificate of need.

(o)  The department may
issue a certificate of need for the new construction, addition or conversion of
skilled nursing facility beds in Leake County, provided that the recipient of
the certificate of need agrees in writing that the skilled nursing facility
will not at any time participate in the Medicaid program (Section 43-13-101 et
seq.) or admit or keep any patients in the skilled nursing facility who are
participating in the Medicaid program.  This written agreement by the recipient
of the certificate of need shall be fully binding on any subsequent owner of
the skilled nursing facility, if the ownership of the facility is transferred
at any time after the issuance of the certificate of need.  Agreement that the
skilled nursing facility will not participate in the Medicaid program shall be
a condition of the issuance of a certificate of need to any person under this
paragraph (o), and if such skilled nursing facility at any time after the
issuance of the certificate of need, regardless of the ownership of the
facility, participates in the Medicaid program or admits or keeps any patients
in the facility who are participating in the Medicaid program, the State
Department of Health shall revoke the certificate of need, if it is still
outstanding, and shall deny or revoke the license of the skilled nursing
facility, at the time that the department determines, after a hearing complying
with due process, that the facility has failed to comply with any of the
conditions upon which the certificate of need was issued, as provided in this
paragraph and in the written agreement by the recipient of the certificate of
need.  The total number of nursing facility beds that may be authorized by any
certificate of need issued under this paragraph (o) shall not exceed sixty (60)
beds.  If the certificate of need authorized under this paragraph is not issued
within twelve (12) months after July 1, 2001, the department shall deny the
application for the certificate of need and shall not issue the certificate of
need at any time after the twelve-month period, unless the issuance is
contested.  If the certificate of need is issued and substantial construction
of the nursing facility beds has not commenced within eighteen (18) months
after July 1, 2001, the State Department of Health, after a hearing complying
with due process, shall revoke the certificate of need if it is still
outstanding, and the department shall not issue a license for the nursing
facility at any time after the eighteen-month period.  However, if the issuance
of the certificate of need is contested, the department shall require
substantial construction of the nursing facility beds within six (6) months
after final adjudication on the issuance of the certificate of need.

(p)  The department may
issue a certificate of need for the construction of a municipally owned nursing
facility within the Town of Belmont in Tishomingo County, not to exceed sixty
(60) beds, provided that the recipient of the certificate of need agrees in
writing that the skilled nursing facility will not at any time participate in
the Medicaid program (Section 43-13-101 et seq.) or admit or keep any patients
in the skilled nursing facility who are participating in the Medicaid program.
This written agreement by the recipient of the certificate of need shall be
fully binding on any subsequent owner of the skilled nursing facility, if the
ownership of the facility is transferred at any time after the issuance of the
certificate of need.  Agreement that the skilled nursing facility will not
participate in the Medicaid program shall be a condition of the issuance of a
certificate of need to any person under this paragraph (p), and if such skilled
nursing facility at any time after the issuance of the certificate of need,
regardless of the ownership of the facility, participates in the Medicaid
program or admits or keeps any patients in the facility who are participating
in the Medicaid program, the State Department of Health shall revoke the
certificate of need, if it is still outstanding, and shall deny or revoke the
license of the skilled nursing facility, at the time that the department
determines, after a hearing complying with due process, that the facility has
failed to comply with any of the conditions upon which the certificate of need
was issued, as provided in this paragraph and in the written agreement by the
recipient of the certificate of need.  The provision of Section 41-7-193(1)
regarding substantial compliance of the projection of need as reported in the
current State Health Plan is waived for the purposes of this paragraph.  If the
certificate of need authorized under this paragraph is not issued within twelve
(12) months after July 1, 1998, the department shall deny the application for
the certificate of need and shall not issue the certificate of need at any time
after the twelve-month period, unless the issuance is contested.  If the
certificate of need is issued and substantial construction of the nursing
facility beds has not commenced within eighteen (18) months after July 1, 1998,
the State Department of Health, after a hearing complying with due process,
shall revoke the certificate of need if it is still outstanding, and the
department shall not issue a license for the nursing facility at any time after
the eighteen-month period.  However, if the issuance of the certificate of need
is contested, the department shall require substantial construction of the
nursing facility beds within six (6) months after final adjudication on the
issuance of the certificate of need.

(q)  (i)  Beginning on
July 1, 1999, the State Department of Health shall issue certificates of need
during each of the next four (4) fiscal years for the construction or expansion
of nursing facility beds or the conversion of other beds to nursing facility
beds in each county in the state having a need for fifty (50) or more
additional nursing facility beds, as shown in the fiscal year 1999 State Health
Plan, in the manner provided in this paragraph (q).  The total number of
nursing facility beds that may be authorized by any certificate of need
authorized under this paragraph (q) shall not exceed sixty (60) beds.

(ii)  Subject to
the provisions of subparagraph (v), during each of the next four (4) fiscal
years, the department shall issue six (6) certificates of need for new nursing
facility beds, as follows:  During fiscal years 2000, 2001 and 2002, one (1)
certificate of need shall be issued for new nursing facility beds in the county
in each of the four (4) Long-Term Care Planning Districts designated in the
fiscal year 1999 State Health Plan that has the highest need in the district
for those beds; and two (2) certificates of need shall be issued for new
nursing facility beds in the two (2) counties from the state at large that have
the highest need in the state for those beds, when considering the need on a
statewide basis and without regard to the Long-Term Care Planning Districts in
which the counties are located.  During fiscal year 2003, one (1) certificate
of need shall be issued for new nursing facility beds in any county having a
need for fifty (50) or more additional nursing facility beds, as shown in the
fiscal year 1999 State Health Plan, that has not received a certificate of need
under this paragraph (q) during the three (3) previous fiscal years.  During
fiscal year 2000, in addition to the six (6) certificates of need authorized in
this subparagraph, the department also shall issue a certificate of need for
new nursing facility beds in Amite County and a certificate of need for new
nursing facility beds in Carroll County.

(iii)  Subject to
the provisions of subparagraph (v), the certificate of need issued under
subparagraph (ii) for nursing facility beds in each Long-Term Care Planning
District during each fiscal year shall first be available for nursing facility
beds in the county in the district having the highest need for those beds, as
shown in the fiscal year 1999 State Health Plan.  If there are no applications
for a certificate of need for nursing facility beds in the county having the
highest need for those beds by the date specified by the department, then the
certificate of need shall be available for nursing facility beds in other
counties in the district in descending order of the need for those beds, from
the county with the second highest need to the county with the lowest need,
until an application is received for nursing facility beds in an eligible
county in the district.

(iv)  Subject to
the provisions of subparagraph (v), the certificate of need issued under
subparagraph (ii) for nursing facility beds in the two (2) counties from the
state at large during each fiscal year shall first be available for nursing
facility beds in the two (2) counties that have the highest need in the state
for those beds, as shown in the fiscal year 1999 State Health Plan, when
considering the need on a statewide basis and without regard to the Long-Term
Care Planning Districts in which the counties are located.  If there are no
applications for a certificate of need for nursing facility beds in either of
the two (2) counties having the highest need for those beds on a statewide
basis by the date specified by the department, then the certificate of need
shall be available for nursing facility beds in other counties from the state
at large in descending order of the need for those beds on a statewide basis,
from the county with the second highest need to the county with the lowest
need, until an application is received for nursing facility beds in an eligible
county from the state at large.

(v)  If a
certificate of need is authorized to be issued under this paragraph (q) for
nursing facility beds in a county on the basis of the need in the Long-Term
Care Planning District during any fiscal year of the four-year period, a
certificate of need shall not also be available under this paragraph (q) for
additional nursing facility beds in that county on the basis of the need in the
state at large, and that county shall be excluded in determining which counties
have the highest need for nursing facility beds in the state at large for that
fiscal year.  After a certificate of need has been issued under this paragraph
(q) for nursing facility beds in a county during any fiscal year of the four-year
period, a certificate of need shall not be available again under this paragraph
(q) for additional nursing facility beds in that county during the four-year
period, and that county shall be excluded in determining which counties have
the highest need for nursing facility beds in succeeding fiscal years.

(vi)  If more than
one (1) application is made for a certificate of need for nursing home facility
beds available under this paragraph (q), in Yalobusha, Newton or Tallahatchie
County, and one (1) of the applicants is a county-owned hospital located in the
county where the nursing facility beds are available, the department shall give
priority to the county-owned hospital in granting the certificate of need if
the following conditions are met:

1.  The county-owned
hospital fully meets all applicable criteria and standards required to obtain a
certificate of need for the nursing facility beds; and

2.  The county-owned
hospital's qualifications for the certificate of need, as shown in its
application and as determined by the department, are at least equal to the
qualifications of the other applicants for the certificate of need.

(r)  (i)  Beginning on
July 1, 1999, the State Department of Health shall issue certificates of need
during each of the next two (2) fiscal years for the construction or expansion
of nursing facility beds or the conversion of other beds to nursing facility
beds in each of the four (4) Long-Term Care Planning Districts designated in
the fiscal year 1999 State Health Plan, to provide care exclusively to patients
with Alzheimer's disease.

(ii)  Not more than
twenty (20) beds may be authorized by any certificate of need issued under this
paragraph (r), and not more than a total of sixty (60) beds may be authorized
in any Long-Term Care Planning District by all certificates of need issued
under this paragraph (r).  However, the total number of beds that may be
authorized by all certificates of need issued under this paragraph (r) during
any fiscal year shall not exceed one hundred twenty (120) beds, and the total
number of beds that may be authorized in any Long-Term Care Planning District
during any fiscal year shall not exceed forty (40) beds.  Of the certificates
of need that are issued for each Long-Term Care Planning District during the
next two (2) fiscal years, at least one (1) shall be issued for beds in the
northern part of the district, at least one (1) shall be issued for beds in the
central part of the district, and at least one (1) shall be issued for beds in
the southern part of the district.

(iii)  The State
Department of Health, in consultation with the Department of Mental Health and
the Division of Medicaid, shall develop and prescribe the staffing levels,
space requirements and other standards and requirements that must be met with
regard to the nursing facility beds authorized under this paragraph (r) to
provide care exclusively to patients with Alzheimer's disease.

(s)  The State
Department of Health may issue a certificate of need to a nonprofit skilled
nursing facility using the Green House model of skilled nursing care and
located in Yazoo City, Yazoo County, Mississippi, for the construction,
expansion or conversion of not more than nineteen (19) nursing facility beds.
For purposes of this paragraph (s), the provisions of Section 41-7-193(1)
requiring substantial compliance with the projection of need as reported in the
current State Health Plan and the provisions of Section 41-7-197 requiring a
formal certificate of need hearing process are waived.  There shall be no
prohibition or restrictions on participation in the Medicaid program for the
person receiving the certificate of need authorized under this paragraph (s).

(t)  The State
Department of Health shall issue certificates of need to the owner of a nursing
facility in operation at the time of Hurricane Katrina in Hancock County that
was not operational on December 31, 2005, because of damage sustained from
Hurricane Katrina to authorize the following:  (i) the construction of a new
nursing facility in Harrison County; (ii) the relocation of forty-nine (49)
nursing facility beds from the Hancock County facility to the new Harrison
County facility; (iii) the establishment of not more than twenty (20) non-Medicaid
nursing facility beds at the Hancock County facility; and (iv) the
establishment of not more than twenty (20) non-Medicaid beds at the new
Harrison County facility.  The certificates of need that authorize the non-Medicaid
nursing facility beds under subparagraphs (iii) and (iv) of this paragraph (t)
shall be subject to the following conditions:  The owner of the Hancock County
facility and the new Harrison County facility must agree in writing that no
more than fifty (50) of the beds at the Hancock County facility and no more
than forty-nine (49) of the beds at the Harrison County facility will be
certified for participation in the Medicaid program, and that no claim will be
submitted for Medicaid reimbursement for more than fifty (50) patients in the
Hancock County facility in any month, or for more than forty-nine (49) patients
in the Harrison County facility in any month, or for any patient in either
facility who is in a bed that is not Medicaid-certified.  This written
agreement by the owner of the nursing facilities shall be a condition of the
issuance of the certificates of need under this paragraph (t), and the
agreement shall be fully binding on any later owner or owners of either
facility if the ownership of either facility is transferred at any time after
the certificates of need are issued.  After this written agreement is executed,
the Division of Medicaid and the State Department of Health shall not certify
more than fifty (50) of the beds at the Hancock County facility or more than
forty-nine (49) of the beds at the Harrison County facility for participation
in the Medicaid program.  If the Hancock County facility violates the terms of
the written agreement by admitting or keeping in the facility on a regular or
continuing basis more than fifty (50) patients who are participating in the
Medicaid program, or if the Harrison County facility violates the terms of the
written agreement by admitting or keeping in the facility on a regular or
continuing basis more than forty-nine (49) patients who are participating in
the Medicaid program, the State Department of Health shall revoke the license
of the facility that is in violation of the agreement, at the time that the
department determines, after a hearing complying with due process, that the
facility has violated the agreement.

(u)  The State
Department of Health shall issue a certificate of need to a nonprofit venture
for the establishment, construction and operation of a skilled nursing facility
of not more than sixty (60) beds to provide skilled nursing care for ventilator
dependent or otherwise medically dependent pediatric patients who require
medical and nursing care or rehabilitation services to be located in a county
in which an academic medical center and a children's hospital are located, and
for any construction and for the acquisition of equipment related to those
beds.  The facility shall be authorized to keep such ventilator dependent or
otherwise medically dependent pediatric patients beyond age twenty-one (21) in
accordance with regulations of the State Board of Health.  For purposes of this
paragraph (u), the provisions of Section 41-7-193(1) requiring substantial
compliance with the projection of need as reported in the current State Health
Plan are waived, and the provisions of Section 41-7-197 requiring a formal
certificate of need hearing process are waived.  The beds authorized by this
paragraph shall be counted as pediatric skilled nursing facility beds for
health planning purposes under Section 41-7-171 et seq.  There shall be no
prohibition of or restrictions on participation in the Medicaid program for the
person receiving the certificate of need authorized by this paragraph.

(3)  The State Department of
Health may grant approval for and issue certificates of need to any person
proposing the new construction of, addition to, conversion of beds of or
expansion of any health care facility defined in subparagraph (x) (psychiatric
residential treatment facility) of Section 41-7-173(h).  The total number of
beds which may be authorized by such certificates of need shall not exceed
three hundred thirty-four (334) beds for the entire state.

(a)  Of the total
number of beds authorized under this subsection, the department shall issue a
certificate of need to a privately owned psychiatric residential treatment
facility in Simpson County for the conversion of sixteen (16) intermediate care
facility for individuals with intellectual disabilities (ICF-IID) beds to
psychiatric residential treatment facility beds, provided that facility agrees
in writing that the facility shall give priority for the use of those sixteen
(16) beds to Mississippi residents who are presently being treated in out-of-state
facilities.

(b)  Of the total
number of beds authorized under this subsection, the department may issue a
certificate or certificates of need for the construction or expansion of
psychiatric residential treatment facility beds or the conversion of other beds
to psychiatric residential treatment facility beds in Warren County, not to
exceed sixty (60) psychiatric residential treatment facility beds, provided
that the facility agrees in writing that no more than thirty (30) of the beds
at the psychiatric residential treatment facility will be certified for
participation in the Medicaid program (Section 43-13-101 et seq.) for the use
of any patients other than those who are participating only in the Medicaid
program of another state, and that no claim will be submitted to the Division
of Medicaid for Medicaid reimbursement for more than thirty (30) patients in
the psychiatric residential treatment facility in any day or for any patient in
the psychiatric residential treatment facility who is in a bed that is not
Medicaid-certified.  This written agreement by the recipient of the certificate
of need shall be a condition of the issuance of the certificate of need under
this paragraph, and the agreement shall be fully binding on any subsequent
owner of the psychiatric residential treatment facility if the ownership of the
facility is transferred at any time after the issuance of the certificate of
need.  After this written agreement is executed, the Division of Medicaid and
the State Department of Health shall not certify more than thirty (30) of the
beds in the psychiatric residential treatment facility for participation in the
Medicaid program for the use of any patients other than those who are
participating only in the Medicaid program of another state.  If the psychiatric
residential treatment facility violates the terms of the written agreement by
admitting or keeping in the facility on a regular or continuing basis more than
thirty (30) patients who are participating in the Mississippi Medicaid program,
the State Department of Health shall revoke the license of the facility, at the
time that the department determines, after a hearing complying with due
process, that the facility has violated the condition upon which the
certificate of need was issued, as provided in this paragraph and in the
written agreement.

The State Department of
Health, on or before July 1, 2002, shall transfer the certificate of need
authorized under the authority of this paragraph (b), or reissue the
certificate of need if it has expired, to River Region Health System.

(c)  Of the total
number of beds authorized under this subsection, the department shall issue a
certificate of need to a hospital currently operating Medicaid-certified acute
psychiatric beds for adolescents in DeSoto County, for the establishment of a
forty-bed psychiatric residential treatment facility in DeSoto County * * *, provided that the hospital agrees in writing (i) that
the hospital shall give priority for the use of those forty (40) beds to
Mississippi residents who are presently being treated in out‑of‑state
facilities, and (ii) that no more than fifteen (15) of the beds at the
psychiatric residential treatment facility will be certified for participation
in the Medicaid program (Section 43‑13‑101 et seq.), and that no
claim will be submitted for Medicaid reimbursement for more than fifteen (15)
patients in the psychiatric residential treatment facility in any day or for
any patient in the psychiatric residential treatment facility who is in a bed
that is not Medicaid‑certified.  This written agreement by the recipient
of the certificate of need shall be a condition of the issuance of the
certificate of need under this paragraph, and the agreement shall be fully
binding on any subsequent owner of the psychiatric residential treatment
facility if the ownership of the facility is transferred at any time after the
issuance of the certificate of need.  After this written agreement is executed,
the Division of Medicaid and the State Department of Health shall not certify
more than fifteen (15) of the beds in the psychiatric residential treatment
facility for participation in the Medicaid program.  If the psychiatric
residential treatment facility violates the terms of the written agreement by
admitting or keeping in the facility on a regular or continuing basis more than
fifteen (15) patients who are participating in the Medicaid program, the State
Department of Health shall revoke the license of the facility, at the time that
the department determines, after a hearing complying with due process, that the
facility has violated the condition upon which the certificate of need was
issued, as provided in this paragraph and in the written agreement.
There shall be no prohibition or restrictions on participation in the
Medicaid program (Section 43-13-101 et seq.) for the person(s) receiving the
certificate of need authorized under this paragraph (c) or for the beds
converted pursuant to the authority of that certificate of need that would not
apply to any other psychiatric residential treatment facility.

(d)  Of the total
number of beds authorized under this subsection, the department may issue a
certificate or certificates of need for the construction or expansion of
psychiatric residential treatment facility beds or the conversion of other beds
to psychiatric treatment facility beds, not to exceed thirty (30) psychiatric
residential treatment facility beds, in either Alcorn, Tishomingo, Prentiss,
Lee, Itawamba, Monroe, Chickasaw, Pontotoc, Calhoun, Lafayette, Union, Benton
or Tippah County.

(e)  Of the total
number of beds authorized under this subsection (3) the department shall issue
a certificate of need to a privately owned, nonprofit psychiatric residential
treatment facility in Hinds County for an eight-bed expansion of the facility,
provided that the facility agrees in writing that the facility shall give
priority for the use of those eight (8) beds to Mississippi residents who are
presently being treated in out-of-state facilities.

(f)  The department
shall issue a certificate of need to a one-hundred-thirty-four-bed specialty
hospital located on twenty-nine and forty-four one-hundredths (29.44)
commercial acres at 5900 Highway 39 North in Meridian (Lauderdale County),
Mississippi, for the addition, construction or expansion of child/adolescent
psychiatric residential treatment facility beds in Lauderdale County.  As a
condition of issuance of the certificate of need under this paragraph, the
facility shall give priority in admissions to the child/adolescent psychiatric
residential treatment facility beds authorized under this paragraph to patients
who otherwise would require out-of-state placement.  The Division of Medicaid,
in conjunction with the Department of Human Services, shall furnish the
facility a list of all out-of-state patients on a quarterly basis.
Furthermore, notice shall also be provided to the parent, custodial parent or
guardian of each out-of-state patient notifying them of the priority status
granted by this paragraph.  For purposes of this paragraph, the provisions of
Section 41-7-193(1) requiring substantial compliance with the projection of
need as reported in the current State Health Plan are waived.  The total number
of child/adolescent psychiatric residential treatment facility beds that may be
authorized under the authority of this paragraph shall be sixty (60) beds.
There shall be no prohibition or restrictions on participation in the Medicaid
program (Section 43-13-101 et seq.) for the person receiving the certificate of
need authorized under this paragraph or for the beds converted pursuant to the
authority of that certificate of need.

(4)  (a)  From and after
March 25, 2021, the department may issue a certificate of need to any person
for the new construction of any hospital, psychiatric hospital or chemical
dependency hospital that will contain any child/adolescent psychiatric or child/adolescent
chemical dependency beds, or for the conversion of any other health care
facility to a hospital, psychiatric hospital or chemical dependency hospital
that will contain any child/adolescent psychiatric or child/adolescent chemical
dependency beds.  There shall be no prohibition or restrictions on
participation in the Medicaid program (Section 43-13-101 et seq.) for the
person(s) receiving the certificate(s) of need authorized under this paragraph
(a) or for the beds converted pursuant to the authority of that certificate of
need.  In issuing any new certificate of need for any child/adolescent psychiatric
or child/adolescent chemical dependency beds, either by new construction or
conversion of beds of another category, the department shall give preference to
beds which will be located in an area of the state which does not have such
beds located in it, and to a location more than sixty-five (65) miles from
existing beds.  Upon receiving 2020 census data, the department may amend the
State Health Plan regarding child/adolescent psychiatric and child/adolescent
chemical dependency beds to reflect the need based on new census data.

(i)  [Deleted]

(ii)  The
department may issue a certificate of need for the conversion of existing beds
in a county hospital in Choctaw County from acute care beds to child/adolescent
chemical dependency beds.  For purposes of this subparagraph (ii), the
provisions of Section 41-7-193(1) requiring substantial compliance with the
projection of need as reported in the current State Health Plan are waived.
The total number of beds that may be authorized under authority of this
subparagraph shall not exceed twenty (20) beds.  There shall be no prohibition
or restrictions on participation in the Medicaid program (Section 43-13-101 et
seq.) for the hospital receiving the certificate of need authorized under this
subparagraph or for the beds converted pursuant to the authority of that
certificate of need.

(iii)  The
department may issue a certificate or certificates of need for the construction
or expansion of child/adolescent psychiatric beds or the conversion of other
beds to child/adolescent psychiatric beds in Warren County.  For purposes of
this subparagraph (iii), the provisions of Section 41-7-193(1) requiring
substantial compliance with the projection of need as reported in the current
State Health Plan are waived.  The total number of beds that may be authorized
under the authority of this subparagraph shall not exceed twenty (20) beds.
There shall be no prohibition or restrictions on participation in the Medicaid
program (Section 43-13-101 et seq.) for the person receiving the certificate of
need authorized under this subparagraph or for the beds converted pursuant to
the authority of that certificate of need.

If by January 1, 2002, there
has been no significant commencement of construction of the beds authorized
under this subparagraph (iii), or no significant action taken to convert
existing beds to the beds authorized under this subparagraph, then the
certificate of need that was previously issued under this subparagraph shall
expire.  If the previously issued certificate of need expires, the department
may accept applications for issuance of another certificate of need for the
beds authorized under this subparagraph, and may issue a certificate of need to
authorize the construction, expansion or conversion of the beds authorized under
this subparagraph.

(iv)  The
department shall issue a certificate of need to the Region 7 Mental
Health/Retardation Commission for the construction or expansion of
child/adolescent psychiatric beds or the conversion of other beds to
child/adolescent psychiatric beds in any of the counties served by the
commission.  For purposes of this subparagraph (iv), the provisions of Section
41-7-193(1) requiring substantial compliance with the projection of need as
reported in the current State Health Plan are waived.  The total number of beds
that may be authorized under the authority of this subparagraph shall not
exceed twenty (20) beds.  There shall be no prohibition or restrictions on
participation in the Medicaid program (Section 43-13-101 et seq.) for the
person receiving the certificate of need authorized under this subparagraph or
for the beds converted pursuant to the authority of that certificate of need.

(v)  The department
may issue a certificate of need to any county hospital located in Leflore
County for the construction or expansion of adult psychiatric beds or the
conversion of other beds to adult psychiatric beds, not to exceed twenty (20)
beds, provided that the recipient of the certificate of need agrees in writing
that the adult psychiatric beds will not at any time be certified for
participation in the Medicaid program and that the hospital will not admit or
keep any patients who are participating in the Medicaid program in any of such
adult psychiatric beds.  This written agreement by the recipient of the
certificate of need shall be fully binding on any subsequent owner of the
hospital if the ownership of the hospital is transferred at any time after the
issuance of the certificate of need.  Agreement that the adult psychiatric beds
will not be certified for participation in the Medicaid program shall be a
condition of the issuance of a certificate of need to any person under this
subparagraph (v), and if such hospital at any time after the issuance of the
certificate of need, regardless of the ownership of the hospital, has any of
such adult psychiatric beds certified for participation in the Medicaid program
or admits or keeps any Medicaid patients in such adult psychiatric beds, the
State Department of Health shall revoke the certificate of need, if it is still
outstanding, and shall deny or revoke the license of the hospital at the time
that the department determines, after a hearing complying with due process,
that the hospital has failed to comply with any of the conditions upon which
the certificate of need was issued, as provided in this subparagraph and in the
written agreement by the recipient of the certificate of need.

(vi)  The
department may issue a certificate or certificates of need for the expansion of
child psychiatric beds or the conversion of other beds to child psychiatric
beds at the University of Mississippi Medical Center.  For purposes of this
subparagraph (vi), the provisions of Section 41-7-193(1) requiring
substantial compliance with the projection of need as reported in the current
State Health Plan are waived.  The total number of beds that may be authorized
under the authority of this subparagraph shall not exceed fifteen (15) beds.
There shall be no prohibition or restrictions on participation in the Medicaid
program (Section 43-13-101 et seq.) for the hospital receiving the certificate
of need authorized under this subparagraph or for the beds converted pursuant
to the authority of that certificate of need.

(b)  From and after
July 1, 1990, no hospital, psychiatric hospital or chemical dependency hospital
shall be authorized to add any child/adolescent psychiatric or child/adolescent
chemical dependency beds or convert any beds of another category to child/adolescent
psychiatric or child/adolescent chemical dependency beds without a certificate
of need under the authority of subsection (1)(c) and subsection (4)(a) of this
section.

(5)  The department may
issue a certificate of need to a county hospital in Winston County for the
conversion of fifteen (15) acute care beds to geriatric psychiatric care beds.

(6)  The State Department of
Health shall issue a certificate of need to a Mississippi corporation qualified
to manage a long-term care hospital as defined in Section 41-7-173(h)(xii) in
Harrison County, not to exceed eighty (80) beds, including any necessary
renovation or construction required for licensure and certification, provided
that the recipient of the certificate of need agrees in writing that the long-term
care hospital will not at any time participate in the Medicaid program (Section
43-13-101 et seq.) * * * or
admit or keep any patients in the long‑term care hospital who are
participating in the Medicaid program except as a crossover
provider.  This written agreement by the recipient of the certificate of
need shall be fully binding on any subsequent owner of the long-term care
hospital, if the ownership of the facility is transferred at any time after the
issuance of the certificate of need.  Agreement that the long-term care
hospital will not participate in the Medicaid program except as a crossover
provider shall be a condition of the issuance of a certificate of need to
any person under this subsection (6), and if such long-term care hospital at
any time after the issuance of the certificate of need, regardless of the
ownership of the facility, participates in the Medicaid program * * * or admits or keeps any patients in the facility who are
participating in the Medicaid program except as a crossover
provider, the State Department of Health shall revoke the certificate of
need, if it is still outstanding, and shall deny or revoke the license of the
long-term care hospital, at the time that the department determines, after a
hearing complying with due process, that the facility has failed to comply with
any of the conditions upon which the certificate of need was issued, as
provided in this subsection and in the written agreement by the recipient of
the certificate of need.  For purposes of this subsection, the provisions of
Section 41-7-193(1) requiring substantial compliance with the projection of
need as reported in the current State Health Plan are waived.  This
subsection (6) shall be retroactive to July 1, 2023.

(7)  The State Department of
Health may issue a certificate of need to any hospital in the state to utilize
a portion of its beds for the "swing-bed" concept.  Any such hospital
must be in conformance with the federal regulations regarding such swing-bed
concept at the time it submits its application for a certificate of need to the
State Department of Health, except that such hospital may have more licensed
beds or a higher average daily census (ADC) than the maximum number specified
in federal regulations for participation in the swing-bed program.  Any
hospital meeting all federal requirements for participation in the swing-bed
program which receives such certificate of need shall render services provided
under the swing-bed concept to any patient eligible for Medicare (Title XVIII
of the Social Security Act) who is certified by a physician to be in need of
such services, and no such hospital shall permit any patient who is eligible
for both Medicaid and Medicare or eligible only for Medicaid to stay in the
swing beds of the hospital for more than thirty (30) days per admission unless
the hospital receives prior approval for such patient from the Division of
Medicaid, Office of the Governor.  Any hospital having more licensed beds or a
higher average daily census (ADC) than the maximum number specified in federal
regulations for participation in the swing-bed program which receives such
certificate of need shall develop a procedure to ensure that before a patient
is allowed to stay in the swing beds of the hospital, there are no vacant
nursing home beds available for that patient located within a fifty-mile radius
of the hospital.  When any such hospital has a patient staying in the swing
beds of the hospital and the hospital receives notice from a nursing home
located within such radius that there is a vacant bed available for that
patient, the hospital shall transfer the patient to the nursing home within a
reasonable time after receipt of the notice.  Any hospital which is subject to
the requirements of the two (2) preceding sentences of this subsection may be
suspended from participation in the swing-bed program for a reasonable period
of time by the State Department of Health if the department, after a hearing
complying with due process, determines that the hospital has failed to comply
with any of those requirements.

(8)  The Department of
Health shall not grant approval for or issue a certificate of need to any
person proposing the new construction of, addition to or expansion of a health
care facility as defined in subparagraph (viii) of Section 41-7-173(h), except
as hereinafter provided:  The department may issue a certificate of need to a
nonprofit corporation located in Madison County, Mississippi, for the
construction, expansion or conversion of not more than twenty (20) beds in a
community living program for developmentally disabled adults in a facility as
defined in subparagraph (viii) of Section 41-7-173(h).  Effective July 1,
2026, the department may shall issue a
certificate of need to the same nonprofit corporation located in Madison
County, Mississippi, for the construction, expansion or conversion of not more than twenty (20) an additional twenty
(20) beds in a community living program for developmentally disabled adults in
a facility as defined in subparagraph (viii) of Section 41-7-173(h).  For
purposes of this subsection (8), the provisions of Section 41-7-193(1)
requiring substantial compliance with the projection of need as reported in the
current State Health Plan and the provisions of Section 41-7-197 requiring a
formal certificate of need hearing process are waived.  There shall be no
prohibition or restrictions on participation in the Medicaid program for the
person receiving the certificate of need authorized under this subsection (8).

(9)  The Department of
Health shall not grant approval for or issue a certificate of need to any
person proposing the establishment of, or expansion of the currently approved
territory of, or the contracting to establish a home office, subunit or branch office
within the space operated as a health care facility as defined in Section 41-7-173(h)(i)
through (viii) by a health care facility as defined in subparagraph (ix) of
Section 41-7-173(h).

(10)  Health care facilities
owned and/or operated by the state or its agencies are exempt from the
restraints in this section against issuance of a certificate of need if such
addition or expansion consists of repairing or renovation necessary to comply
with the state licensure law.  This exception shall not apply to the new
construction of any building by such state facility.  This exception shall not
apply to any health care facilities owned and/or operated by counties,
municipalities, districts, unincorporated areas, other defined persons, or any
combination thereof.

(11)  The new construction,
renovation or expansion of or addition to any health care facility defined in
subparagraph (ii) (psychiatric hospital), subparagraph (iv) (skilled nursing
facility), subparagraph (vi) (intermediate care facility), subparagraph (viii)
(intermediate care facility for individuals with intellectual disabilities) and
subparagraph (x) (psychiatric residential treatment facility) of Section 41-7-173(h)
which is owned by the State of Mississippi and under the direction and control
of the State Department of Mental Health, and the addition of new beds or the
conversion of beds from one category to another in any such defined health care
facility which is owned by the State of Mississippi and under the direction and
control of the State Department of Mental Health, shall not require the
issuance of a certificate of need under Section 41-7-171 et seq.,
notwithstanding any provision in Section 41-7-171 et seq. to the contrary.

(12)  The new construction,
renovation or expansion of or addition to any veterans homes or domiciliaries
for eligible veterans of the State of Mississippi as authorized under Section
35-1-19 shall not require the issuance of a certificate of need,
notwithstanding any provision in Section 41-7-171 et seq. to the contrary.

(13)  The repair or the
rebuilding of an existing, operating health care facility that sustained
significant damage from a natural disaster that occurred after April 15, 2014,
in an area that is proclaimed a disaster area or subject to a state of emergency
by the Governor or by the President of the United States shall be exempt from
all of the requirements of the Mississippi Certificate of Need Law (Section 41-7-171
et seq.) and any and all rules and regulations promulgated under that law,
subject to the following conditions:

(a)  The repair or the
rebuilding of any such damaged health care facility must be within one (1) mile
of the pre-disaster location of the campus of the damaged health care facility,
except that any temporary post-disaster health care facility operating location
may be within five (5) miles of the pre-disaster location of the damaged health
care facility;

(b)  The repair or the
rebuilding of the damaged health care facility (i) does not increase or change
the complement of its bed capacity that it had before the Governor's or the
President's proclamation, (ii) does not increase or change its levels and types
of health care services that it provided before the Governor's or the
President's proclamation, and (iii) does not rebuild in a different county;
however, this paragraph does not restrict or prevent a health care facility
from decreasing its bed capacity that it had before the Governor's or the
President's proclamation, or from decreasing the levels of or decreasing or
eliminating the types of health care services that it provided before the
Governor's or the President's proclamation, when the damaged health care
facility is repaired or rebuilt;

(c)  The exemption from
Certificate of Need Law provided under this subsection (13) is valid for only
five (5) years from the date of the Governor's or the President's
proclamation.  If actual construction has not begun within that five-year
period, the exemption provided under this subsection is inapplicable; and

(d)  The Division of
Health Facilities Licensure and Certification of the State Department of Health
shall provide the same oversight for the repair or the rebuilding of the
damaged health care facility that it provides to all health care facility
construction projects in the state.

For the purposes of this
subsection (13), "significant damage" to a health care facility means
damage to the health care facility requiring an expenditure of at least One
Million Dollars ($1,000,000.00).

(14)  The State Department
of Health shall issue a certificate of need to any hospital which is currently
licensed for two hundred fifty (250) or more acute care beds and is located in
any general hospital service area not having a comprehensive cancer center, for
the establishment and equipping of such a center which provides facilities and
services for outpatient radiation oncology therapy, outpatient medical oncology
therapy, and appropriate support services including the provision of radiation
therapy services.  The provisions of Section 41-7-193(1) regarding substantial
compliance with the projection of need as reported in the current State Health
Plan are waived for the purpose of this subsection.

(15)  The State Department
of Health may authorize the transfer of hospital beds, not to exceed sixty (60)
beds, from the North Panola Community Hospital to the South Panola Community
Hospital.  The authorization for the transfer of those beds shall be exempt
from the certificate of need review process.

(16)  The State Department
of Health shall issue any certificates of need necessary for Mississippi State
University and a public or private health care provider to jointly acquire and
operate a linear accelerator and a magnetic resonance imaging unit.  Those
certificates of need shall cover all capital expenditures related to the
project between Mississippi State University and the health care provider,
including, but not limited to, the acquisition of the linear accelerator, the
magnetic resonance imaging unit and other radiological modalities; the offering
of linear accelerator and magnetic resonance imaging services; and the cost of
construction of facilities in which to locate these services.  The linear
accelerator and the magnetic resonance imaging unit shall be (a) located in the
City of Starkville, Oktibbeha County, Mississippi; (b) operated jointly by
Mississippi State University and the public or private health care provider
selected by Mississippi State University through a request for proposals (RFP)
process in which Mississippi State University selects, and the Board of
Trustees of State Institutions of Higher Learning approves, the health care
provider that makes the best overall proposal; (c) available to Mississippi
State University for research purposes two-thirds (2/3) of the time that the
linear accelerator and magnetic resonance imaging unit are operational; and (d)
available to the public or private health care provider selected by Mississippi
State University and approved by the Board of Trustees of State Institutions of
Higher Learning one-third (1/3) of the time for clinical, diagnostic and
treatment purposes.  For purposes of this subsection, the provisions of Section
41-7-193(1) requiring substantial compliance with the projection of need as
reported in the current State Health Plan are waived.

(17)  The State Department
of Health shall issue a certificate of need for the construction of an acute
care hospital in Kemper County, not to exceed twenty-five (25) beds, which
shall be named the "John C. Stennis Memorial Hospital."  In issuing
the certificate of need under this subsection, the department shall give
priority to a hospital located in Lauderdale County that has two hundred
fifteen (215) beds.  For purposes of this subsection, the provisions of Section
41-7-193(1) requiring substantial compliance with the projection of need as
reported in the current State Health Plan and the provisions of Section 41-7-197
requiring a formal certificate of need hearing process are waived.  There shall
be no prohibition or restrictions on participation in the Medicaid program
(Section 43-13-101 et seq.) for the person or entity receiving the certificate
of need authorized under this subsection or for the beds constructed under the
authority of that certificate of need.

(18)  The planning, design,
construction, renovation, addition, furnishing and equipping of a clinical
research unit at any health care facility defined in Section 41-7-173(h) that
is under the direction and control of the University of Mississippi Medical
Center and located in Jackson, Mississippi, and the addition of new beds or the
conversion of beds from one (1) category to another in any such clinical
research unit, shall not require the issuance of a certificate of need under
Section 41-7-171 et seq., notwithstanding any provision in Section 41-7-171 et
seq. to the contrary.

(19)  [Repealed]

(20)  Nothing in this
section or in any other provision of Section 41-7-171 et seq. shall prevent any
nursing facility from designating an appropriate number of existing beds in the
facility as beds for providing care exclusively to patients with Alzheimer's
disease.

(21)  Nothing in this
section or any other provision of Section 41-7-171 et seq. shall prevent any
health care facility from the new construction, renovation, conversion or
expansion of new beds in the facility designated as intensive care units,
negative pressure rooms, or isolation rooms pursuant to the provisions of Sections
41-14-1 through 41-14-11, or Section 41-14-31.  For purposes of this
subsection, the provisions of Section 41-7-193(1) requiring substantial
compliance with the projection of need as reported in the current State Health
Plan and the provisions of Section 41-7-197 requiring a formal certificate of
need hearing process are waived.

(22)  Except as provided
in this subsection (22), the University of Mississippi Medical Center shall
comply with all of the provisions of Section 41-7-171 et seq.

The University of
Mississippi Medical Center need not obtain a certificate of need for any
hospital beds, services, health care facilities, or medical equipment that have
been approved and continuously operated under a certificate of need exemption
for a teaching hospital, or that are approved or applied for
before the effective date of this act, as long as they do not undergo a
physical relocation.

From and after the
effective date of this act, the University of Mississippi Medical Center has an
academic exemption from the certificate of need requirements of Section 41-7-171
et seq. only within the following area in the City of Jackson, Mississippi:
starting at the intersection of Livingston Road and Woodrow Wilson Avenue,
proceeding east along the south curb line of Woodrow Wilson Avenue until it
intersects the west curb line of U.S. Interstate 55, proceeding north along the
west curb line of U.S. Interstate 55 until it intersects the north curb line of
Lakeland Drive, proceeding west along the north curb line of Lakeland Drive and
extending such curb line west until it intersects Livingston Road, and
proceeding south along the west curb line of Livingston Road to the point of
origin.

In order to qualify for
an academic exemption, under this subsection, the State Health Officer must
determine that the proposed equipment or facility fulfills a substantial and
meaningful academic function.

(23)  (a)  The State
Department of Health shall conduct a study to review and make recommendations
regarding Section 41-7-171 et seq., to be specifically focused on the following
topics:

(i)  The
feasibility of exempting small hospitals from the requirement for a certificate
of need for the placement of dialysis units to reduce the number of transfers
for patients requiring dialysis;

(ii)  The
feasibility of exempting small hospitals from the requirement for a certificate
of need to operate geriatric psychiatric units; and

(iii)  The
feasibility of a new requirement that acute adult psychiatric units treat a
certain percentage of uninsured patients or pay a periodic fee in lieu thereof.

(b)  The department
shall make a final report of its findings and recommendations, including any
recommended legislation and funding needs, to the Legislature before December
1, 2026.

SECTION 2.  Section
41-7-173, Mississippi Code of 1972, is amended as follows:

41-7-173.  For the purposes
of Section 41-7-171 et seq., the following words shall have the meanings
ascribed herein, unless the context otherwise requires:

(a)  "Affected
person" means (i) the applicant; (ii) a person residing within the
geographic area to be served by the applicant's proposal; (iii) a person who
regularly uses health care facilities or HMOs located in the geographic area of
the proposal which provide similar service to that which is proposed; (iv)
health care facilities and HMOs which have, prior to receipt of the application
under review, formally indicated an intention to provide service similar to
that of the proposal being considered at a future date; (v) third-party payers
who reimburse health care facilities located in the geographical area of the
proposal; or (vi) any agency that establishes rates for health care services or
HMOs located in the geographic area of the proposal.

(b)  "Certificate
of need" means a written order of the State Department of Health setting
forth the affirmative finding that a proposal in prescribed application form,
sufficiently satisfies the plans, standards and criteria prescribed for such
service or other project by Section 41-7-171 et seq., and by rules and
regulations promulgated thereunder by the State Department of Health.

(c)  (i)  "Capital
expenditure," when pertaining to defined major medical equipment, shall
mean an expenditure which, under generally accepted accounting principles
consistently applied, is not properly chargeable as an expense of operation and
maintenance and which exceeds * * * One Million Five Hundred Thousand Dollars ($1,500,000.00)
Three Million Dollars ($3,000,000.00).

(ii)  "Capital
expenditure," when pertaining to other than major medical equipment, shall
mean any expenditure which under generally accepted accounting principles
consistently applied is not properly chargeable as an expense of operation and
maintenance and which exceeds, for clinical health services, as defined in
paragraph (k) below, * * *
Five Million Dollars ($5,000,000.00) Ten Million Dollars
($10,000,000.00), * * *
adjusted for inflation as published by the State Department of Health
or which exceeds, for nonclinical health services, as defined in paragraph (k)
below, * * * Ten Million
Dollars ($10,000,000.00), adjusted for inflation as published by the State
Department of Health Twenty Million Dollars ($20,000,000.00).

(iii)  A
"capital expenditure" shall include the acquisition, whether by
lease, sufferance, gift, devise, legacy, settlement of a trust or other means,
of any facility or part thereof, or equipment for a facility, the expenditure
for which would have been considered a capital expenditure if acquired by
purchase.  Transactions which are separated in time but are planned to be
undertaken within twelve (12) months of each other and are components of an
overall plan for meeting patient care objectives shall, for purposes of this
definition, be viewed in their entirety without regard to their timing.

(iv)  In those
instances where a health care facility or other provider of health services
proposes to provide a service in which the capital expenditure for major
medical equipment or other than major medical equipment or a combination of the
two (2) may have been split between separate parties, the total capital
expenditure required to provide the proposed service shall be considered in
determining the necessity of certificate of need review and in determining the
appropriate certificate of need review fee to be paid.  The capital expenditure
associated with facilities and equipment to provide services in Mississippi
shall be considered regardless of where the capital expenditure was made, in
state or out of state, and regardless of the domicile of the party making the
capital expenditure, in state or out of state.

(d)  "Change of
ownership" includes, but is not limited to, inter vivos gifts, purchases,
transfers, lease arrangements, cash and/or stock transactions or other
comparable arrangements whenever any person or entity acquires or controls a
majority interest of an existing health care facility, and/or the change of
ownership of major medical equipment, a health service, or an institutional
health service.  Changes of ownership from partnerships, single proprietorships
or corporations to another form of ownership are specifically included.
However, "change of ownership" shall not include any inherited
interest acquired as a result of a testamentary instrument or under the laws of
descent and distribution of the State of Mississippi.

(e)  "Commencement
of construction" means that all of the following have been completed with
respect to a proposal or project proposing construction, renovating, remodeling
or alteration:

(i)  A legally
binding written contract has been consummated by the proponent and a lawfully
licensed contractor to construct and/or complete the intent of the proposal
within a specified period of time in accordance with final architectural plans
which have been approved by the licensing authority of the State Department of
Health;

(ii)  Any and all
permits and/or approvals deemed lawfully necessary by all authorities with
responsibility for such have been secured; and

(iii)  Actual bona
fide undertaking of the subject proposal has commenced, and a progress payment
of at least one percent (1%) of the total cost price of the contract has been
paid to the contractor by the proponent, and the requirements of this paragraph
(e) have been certified to in writing by the State Department of Health.

Force account expenditures,
such as deposits, securities, bonds, et cetera, may, in the discretion of the
State Department of Health, be excluded from any or all of the provisions of
defined commencement of construction.

(f)
"Consumer" means an individual who is not a provider of health care
as defined in paragraph (q) of this section.

(g)
"Develop," when used in connection with health services, means to
undertake those activities which, on their completion, will result in the
offering of a new institutional health service or the incurring of a financial
obligation as defined under applicable state law in relation to the offering of
such services.

(h)  "Health care
facility" includes hospitals, psychiatric hospitals, chemical dependency
hospitals, skilled nursing facilities, end-stage renal disease (ESRD)
facilities, including freestanding hemodialysis units, intermediate care
facilities, ambulatory surgical facilities, intermediate care facilities for
individuals with intellectual disabilities, home health agencies, psychiatric
residential treatment facilities, pediatric skilled nursing facilities, long-term
care hospitals, comprehensive medical rehabilitation facilities, including
facilities owned or operated by the state or a political subdivision or
instrumentality of the state, but does not include Christian Science
sanatoriums operated or listed and certified by the First Church of Christ,
Scientist, Boston, Massachusetts.  This definition shall not apply to
facilities for the private practice, either independently or by incorporated
medical groups, of physicians, dentists or health care professionals except
where such facilities are an integral part of an institutional health service.
The various health care facilities listed in this paragraph shall be defined as
follows:

(i)
"Hospital" means an institution which is primarily engaged in
providing to inpatients, by or under the supervision of physicians, diagnostic
services and therapeutic services for medical diagnosis, treatment and care of
injured, disabled or sick persons, or rehabilitation services for the
rehabilitation of injured, disabled or sick persons.  Such term does not
include psychiatric hospitals.

(ii)
"Psychiatric hospital" means an institution which is primarily
engaged in providing to inpatients, by or under the supervision of a physician,
psychiatric services for the diagnosis and treatment of persons with mental illness.

(iii)
"Chemical dependency hospital" means an institution which is
primarily engaged in providing to inpatients, by or under the supervision of a
physician, medical and related services for the diagnosis and treatment of
chemical dependency such as alcohol and drug abuse.

(iv)  "Skilled
nursing facility" means an institution or a distinct part of an
institution which is primarily engaged in providing to inpatients skilled
nursing care and related services for patients who require medical or nursing
care or rehabilitation services for the rehabilitation of injured, disabled or
sick persons.

(v)  "End-stage
renal disease (ESRD) facilities" means kidney disease treatment centers,
which includes freestanding hemodialysis units and limited care facilities.
The term "limited care facility" generally refers to an off-hospital-premises
facility, regardless of whether it is provider or nonprovider operated, which
is engaged primarily in furnishing maintenance hemodialysis services to
stabilized patients.

(vi)
"Intermediate care facility" means an institution which provides, on
a regular basis, health-related care and services to individuals who do not
require the degree of care and treatment which a hospital or skilled nursing
facility is designed to provide, but who, because of their mental or physical
condition, require health-related care and services (above the level of room
and board).

(vii)
"Ambulatory surgical facility" means a facility primarily organized
or established for the purpose of performing surgery for outpatients and is a
separate identifiable legal entity from any other health care facility.  Such
term does not include the offices of private physicians or dentists, whether
for individual or group practice, and does not include any abortion facility as
defined in Section 41-75-1(f).

(viii)
"Intermediate care facility for individuals with intellectual
disabilities" means an intermediate care facility that provides health or
rehabilitative services in a planned program of activities to persons with an intellectual disability, also
including, but not limited to, cerebral palsy and other conditions covered by
the Federal Developmentally Disabled Assistance and Bill of Rights Act, Public
Law 94-103.

(ix)  "Home
health agency" means a public or privately owned agency or organization,
or a subdivision of such an agency or organization, properly authorized to
conduct business in Mississippi, which is primarily engaged in providing to
individuals at the written direction of a licensed physician, in the
individual's place of residence, skilled nursing services provided by or under
the supervision of a registered nurse licensed to practice in Mississippi, and
one or more of the following services or items:

1.  Physical,
occupational or speech therapy;

2.  Medical
social services;

3.  Part-time
or intermittent services of a home health aide;

4.  Other
services as approved by the licensing agency for home health agencies;

5.  Medical
supplies, other than drugs and biologicals, and the use of medical appliances;
or

6.  Medical
services provided by an intern or resident-in-training at a hospital under a
teaching program of such hospital.

Further, all skilled nursing
services and those services listed in items 1 through 4 of this subparagraph
(ix) must be provided directly by the licensed home health agency.  For
purposes of this subparagraph, "directly" means either through an agency
employee or by an arrangement with another individual not defined as a health
care facility.

This subparagraph (ix) shall
not apply to health care facilities which had contracts for the above services
with a home health agency on January 1, 1990.

(x)
"Psychiatric residential treatment facility" means any nonhospital
establishment with permanent licensed facilities which provides a twenty-four-hour
program of care by qualified therapists, including, but not limited to, duly
licensed mental health professionals, psychiatrists, psychologists,
psychotherapists and licensed certified social workers, for emotionally
disturbed children and adolescents referred to such facility by a court, local
school district or by the Department of Human Services, who are not in an acute
phase of illness requiring the services of a psychiatric hospital, and are in
need of such restorative treatment services.  For purposes of this
subparagraph, the term "emotionally disturbed" means a condition
exhibiting one or more of the following characteristics over a long period of
time and to a marked degree, which adversely affects educational performance:

1.  An
inability to learn which cannot be explained by intellectual, sensory or health
factors;

2.  An
inability to build or maintain satisfactory relationships with peers and
teachers;

3.
Inappropriate types of behavior or feelings under normal circumstances;

4.  A general
pervasive mood of unhappiness or depression; or

5.  A tendency
to develop physical symptoms or fears associated with personal or school
problems.  An establishment furnishing primarily domiciliary care is not within
this definition.

(xi)
"Pediatric skilled nursing facility" means an institution or a
distinct part of an institution that is primarily engaged in providing to
inpatients skilled nursing care and related services for persons under twenty-one
(21) years of age who require medical or nursing care or rehabilitation
services for the rehabilitation of injured, disabled or sick persons.

(xii)  "Long-term
care hospital" means a freestanding, Medicare-certified hospital that has
an average length of inpatient stay greater than twenty-five (25) days, which
is primarily engaged in providing chronic or long-term medical care to patients
who do not require more than three (3) hours of rehabilitation or comprehensive
rehabilitation per day, and has a transfer agreement with an acute care medical
center and a comprehensive medical rehabilitation facility.  Long-term care
hospitals shall not use rehabilitation, comprehensive medical rehabilitation,
medical rehabilitation, sub-acute rehabilitation, nursing home, skilled nursing
facility or sub-acute care facility in association with its name.

(xiii)
"Comprehensive medical rehabilitation facility" means a hospital or
hospital unit that is licensed and/or certified as a comprehensive medical
rehabilitation facility which provides specialized programs that are accredited
by the Commission on Accreditation of Rehabilitation Facilities and supervised
by a physician board certified or board eligible in physiatry or other doctor
of medicine or osteopathy with at least two (2) years of training in the
medical direction of a comprehensive rehabilitation program that:

1.  Includes
evaluation and treatment of individuals with physical disabilities;

2.  Emphasizes
education and training of individuals with disabilities;

3.
Incorporates at least the following core disciplines:

a.
Physical Therapy;

b.
Occupational Therapy;

c.
Speech and Language Therapy;

d.
Rehabilitation Nursing; and

4.
Incorporates at least three (3) of the following disciplines:

a.
Psychology;

b.
Audiology;

c.
Respiratory Therapy;

d.
Therapeutic Recreation;

e.
Orthotics;

f.
Prosthetics;

g.
Special Education;

h.
Vocational Rehabilitation;

i.
Psychotherapy;

j.
Social Work;

k.
Rehabilitation Engineering.

These specialized programs
include, but are not limited to:  spinal cord injury programs, head injury
programs and infant and early childhood development programs.

(i)  "Health
maintenance organization" or "HMO" means a public or private
organization organized under the laws of this state or the federal government
which:

(i)  Provides or
otherwise makes available to enrolled participants health care services,
including substantially the following basic health care services:  usual
physician services, hospitalization, laboratory, x-ray, emergency and
preventive services, and out-of-area coverage;

(ii)  Is
compensated (except for copayments) for the provision of the basic health care
services listed in subparagraph (i) of this paragraph to enrolled participants
on a predetermined basis; and

(iii)  Provides
physician services primarily:

1.  Directly
through physicians who are either employees or partners of such organization;
or

2.  Through
arrangements with individual physicians or one or more groups of physicians
(organized on a group practice or individual practice basis).

(j)  "Health
service area" means a geographic area of the state designated in the State
Health Plan as the area to be used in planning for specified health facilities
and services and to be used when considering certificate of need applications
to provide health facilities and services.

(k)  "Health
services" means clinically related (i.e., diagnostic, treatment or
rehabilitative) services and includes alcohol, drug abuse, mental health and
home health care services.  "Clinical health services" shall only
include those activities which contemplate any change in the existing bed
complement of any health care facility through the addition or conversion of
any beds, under Section 41-7-191(1)(c) or propose to offer any health services
if those services have not been provided on a regular basis by the proposed
provider of such services within the period of twelve (12) months prior to the
time such services would be offered, under Section 41-7-191(1)(d).
"Nonclinical health services" shall be all other services which do
not involve any change in the existing bed complement or offering health
services as described above.

(l)
"Institutional health services" shall mean health services provided
in or through health care facilities and shall include the entities in or
through which such services are provided.

(m)  "Major
medical equipment" means medical equipment designed for providing medical
or any health-related service which costs in excess of * * * One Million Five Hundred Thousand Dollars ($1,500,000.00)
Three Million Dollars ($3,000,000.00).  However, this definition shall
not be applicable to clinical laboratories if they are determined by the State
Department of Health to be independent of any physician's office, hospital or
other health care facility or otherwise not so defined by federal or state law,
or rules and regulations promulgated thereunder.

(n)  "State
Department of Health" or "department" shall mean the state
agency created under Section 41-3-15, which shall be considered to be the State
Health Planning and Development Agency, as defined in paragraph (u) of this
section.

(o)  "Offer,"
when used in connection with health services, means that it has been determined
by the State Department of Health that the health care facility is capable of
providing specified health services.

(p)  "Person"
means an individual, a trust or estate, partnership, corporation (including
associations, joint-stock companies and insurance companies), the state or a
political subdivision or instrumentality of the state.

(q)
"Provider" shall mean any person who is a provider or representative
of a provider of health care services requiring a certificate of need under
Section 41-7-171 et seq., or who has any financial or indirect interest in any
provider of services.

(r)  "Radiation
therapy services" means the treatment of cancer and other diseases using
ionizing radiation of either high energy photons (x-rays or gamma rays) or
charged particles (electrons, protons or heavy nuclei).  However, for purposes
of a certificate of need, radiation therapy services shall not include low
energy, superficial, external beam x-ray treatment of superficial skin lesions.

(s)
"Secretary" means the Secretary of Health and Human Services, and any
officer or employee of the Department of Health and Human Services to whom the
authority involved has been delegated.

(t)  "State Health
Plan" means the sole and official statewide health plan for Mississippi
which identifies priority state health needs and establishes standards and
criteria for health-related activities which require certificate of need review
in compliance with Section 41-7-191.

(u)  "State Health
Planning and Development Agency" means the agency of state government
designated to perform health planning and resource development programs for the
State of Mississippi.

SECTION 3.  This act
shall take effect and be in force from and after its passage.