Virginia Law

A. The parties shall report annually to the commissioner on the extent of the benefits realized and compliance with any terms and conditions placed on their letter authorizing cooperative agreement. The report shall:

1. Describe the activities conducted pursuant to the cooperative agreement;

2. Include any actions taken in furtherance of commitments made by the parties or terms imposed by the commissioner as a condition for approval of the cooperative agreement;

3. Include information related to changes in price, cost, quality, access to care, and population health improvement;

4. Include actual costs, revenues, profit margins, and operating costs;

5. Include a charge master;

6. Include information reflecting the contracted rates negotiated with nonphysician providers, allied health professionals, and others;

7. Include any measures requested by the department based on the recommendations of the technical advisory panel appointed pursuant to 12VAC5-221-120; and

8. Include the current status of the quantitative measures and the information requested by the department for benchmarks established in 12VAC5-221-100 D.

B. The commissioner may require the parties to supplement the annual report with additional information to the extent necessary to ensure compliance with the cooperative agreement and the letter authorizing cooperative agreement.

C. All annual reports submitted pursuant to this section shall be certified audited by a third-party auditor.

D. The parties shall reimburse the commissioner for all costs and expenses deemed necessary by the commissioner regarding the ongoing and active supervision of the cooperative agreement, including costs of experts and consultants retained by the commissioner.

E. The parties shall:

1. Remit payment only by certified check, cashier's check, bank money order, or other methods approved by the commissioner;

2. Make all payments payable to the department; and

3. Submit payment to the department 30 days after the receipt of a request for reimbursement from the commissioner.

F. The commissioner shall:

1. Maintain detailed records of all costs incurred for which reimbursement is sought;

2. Incur only those expenses necessary to actively supervise the cooperative agreement as determined in the commissioner's sole discretion; and

3. Provide the parties a written quarterly report detailing all costs incurred by the commissioner related to the supervision of the cooperative agreement for which the commissioner seeks reimbursement within 30 days of the end of each quarter.

G. Prior to contracting with experts or consultants, the commissioner shall provide a seven-day notice to the parties describing the proposed scope of work and anticipated costs of those experts and consultants.

H. The parties shall have seven days from the date of receipt of the commissioner's notice pursuant to subsection G of this section to provide to the commissioner possible alternatives to the use of those experts or consultants.

I. The commissioner shall consider information submitted by the parties in determining whether to retain an expert or consultant.

J. All reimbursement requests by the commissioner shall be subject to the provisions of § 2.2-4805 of the Code of Virginia.

K. The commissioner shall annually issue a written decision and the basis for the decision as to whether the benefits of the cooperative agreement continue to outweigh the disadvantages attributable to a reduction in competition that have resulted from the cooperative agreement.