Virginia Law

A. The commissioner shall maintain active and continuing supervision of the parties in accordance with the terms under this section and to ensure compliance with the cooperative agreement and the letter authorizing cooperative agreement.

B. Any party who receives an authorization letter shall submit any information that is requested by the commissioner for ongoing monitoring and supervision. The commissioner may designate the department to request and to receive additional information from the parties.

C. In the selection of the measures for reviewing the proposed benefits of the cooperative agreement and during the monitoring and active supervision of any approved cooperative agreement, the commissioner shall:

1. Draw from consensus health and health care metrics, such as those being developed pursuant to the state health improvement plan to ensure validity and consistency of the measure;

2. Use historical, actual experience in the region to establish baseline performance and evaluate progress over time;

3. Consider recommendations on the measures and goals from the TAP appointed pursuant to 12VAC5-221-120; and

4. Allow for flexibility, to the extent quantifiable goals and targets are specified, should environmental factors that are outside the control of the parties change significantly.

D. The commissioner shall establish benchmarks and quantitative measures that will be used to evaluate the proposed and continuing benefits of the cooperative agreement. The quantitative measures shall include measures of the identifiable benefits from the cooperative agreement in at least the following categories:

1. Population health;

2. Access to health services;

3. Economic;

4. Patient safety;

5. Patient satisfaction; and

6. Health outcomes.

E. The TAP and the parties of the cooperative agreement may make recommendations for the creation and evaluation of quantitative measures, but the commissioner shall have the exclusive authority to add, modify, accept, or reject recommendations when creating or interpreting the quantitative measures.

F. Upon receipt of any requested additional information submitted pursuant to subsection B of this section, the commissioner shall notify the parties within 45 days regarding whether the additional information satisfies the commissioner's request.

G. The parties shall:

1. Report any update to the parties' plan of separation; and

2. Submit the updated plan of separation to the commissioner within 30 days of that update with an independent opinion from a qualified organization that states the plan of separation may be operationally implemented without undue disruption to essential health services provided by the parties.

H. The commissioner may (i) develop other mechanisms of monitoring the parties to determine compliance with the cooperative agreement and whether compliance continues to meet the requirements of § 15.2-5384.1 of the Code of Virginia and (ii) modify the mechanisms of monitoring the parties upon notice to the parties.