Chapter 20. Regulations Governing Practitioner Self-Referral
Part I
General Provisions
18VAC75-20-10. Definitions.
Statutory definitions of words and terms related to the Practitioner Self-Referral Act are established in § 54.1-2410 of the Code of Virginia.
The following additional words and terms when used in this chapter shall have the following meanings, unless the context clearly indicates otherwise:
"Act" means the Practitioner Self-Referral Act, Chapter 24.1 (§ 54.1-2410 et seq.) of Title 54.1 of the Code of Virginia.
"Applicant" means a practitioner or entity who has applied to the board for an advisory opinion on the applicability of the Act, or for an exception to the prohibitions of the Act.
"Appropriate regulatory board" means the regulatory board within the Department of Health Professions which licenses or certifies the practitioner.
"Board" means the Board of Health Professions.
"Committee" means an informal conference committee of the Board of Health Professions.
"Department" means the Department of Health Professions.
Statutory Authority
§ 54.1-2412 of the Code of Virginia.
Historical Notes
Derived from VR365-01-2 § 1.1, eff. March 24, 1994; amended, Virginia Register Volume 15, Issue 18, eff. June 23, 1999.
18VAC75-20-20. Public Participation Guidelines.
18VAC75-10-10 establishes the guidelines for participation by the public in rulemaking activities of the board.
Statutory Authority
§§ 54.1-2501 and 54.1-2510 of the Code of Virginia.
Historical Notes
Derived from VR365-01-2 § 1.2, eff. March 24, 1994.
18VAC75-20-30. (Repealed.)
Historical Notes
Derived from VR365-01-2 §§ 2.1 to 2.3, eff. March 24, 1994; repealed, Virginia Register Volume 15, Issue 18, eff. June 23, 1999.
Part II
Advisory Opinions and Exceptions
18VAC75-20-60. Application for advisory opinions.
A. Any practitioner or entity may request an advisory opinion on the applicability of the Act upon completion of an application and payment of a fee.
B. Requests shall be made on an application form prescribed by the board. The request shall contain the following information:
1. The name of the practitioner or entity;
2. Identification of the practitioner or entity and description of the health care services being provided or proposed;
3. The type and amount of existing or proposed investment interest in the entity;
4. A description of the nature of the investment interest and copies of any existing or proposed documents between the practitioner and the entity including but not limited to leases, contracts, organizational documents, etc.; and
5. Certification and notarized signature of the practitioner or principal of the entity requesting the advisory opinion that the information and supporting documentation contained therein is true and correct.
C. The application shall be reviewed for completeness, and the board may request such other additional information or documentation it deems necessary from the practitioner or entity.
D. Upon a determination that a request for an advisory opinion is complete and that it has sufficient information, the board shall notify the practitioner or entity that it will consider its request.
E. At the conclusion of an informal conference, the committee shall issue an advisory opinion to the practitioner or entity, which shall be presented for ratification by the board.
Statutory Authority
§§ 54.1-2400 and 54.1-2412 of the Code of Virginia.
Historical Notes
Derived from VR365-01-2 § 3.1, eff. March 24, 1994; amended, Virginia Register Volume 15, Issue 18, eff. June 23, 1999; Volume 23, Issue 21, eff. September 10, 2007.
18VAC75-20-70. Application for exception.
A. A practitioner or entity may request an exception to the prohibitions of the Act upon completion of an application and payment of a fee.
B. Requests shall be made on an application form prescribed by the board. The application shall contain the following information:
1. The name and identifying information of the practitioner or entity;
2. The information and documentation regarding community need and alternative financing as required by § 54.1-2411 B of the Code of Virginia;
3. Certification and notarized signature of the practitioner or principal of the entity requesting the exception that the information contained in the application and supporting documentation is true and correct.
C. The application shall be reviewed for completeness, and the board may request additional information and documentation from the applicant.
D. Upon a determination that an application is complete and that it has sufficient information, the board shall notify the applicant that it will consider the request.
E. At the conclusion of an informal conference, the committee shall issue a decision regarding the request for an exception to the applicant, which shall be presented for ratification by the board.
F. Exceptions to the Act shall be valid for a period of no more than five years.
G. Subject to verification by the board, an exception shall be renewed upon payment of a renewal fee and the receipt of certification from the practitioner or entity that the conditions under which the original exception was granted continue to warrant the exception.
Statutory Authority
§§ 54.1-2400 and 54.1-2412 of the Code of Virginia.
Historical Notes
Derived from VR365-01-2 § 3.2, eff. March 24, 1994; amended, Virginia Register Volume 15, Issue 18, eff. June 23, 1999; Volume 23, Issue 21, eff. September 10, 2007.
18VAC75-20-80. Fees.
A. An application fee for an opinion on applicability of the Act shall be $500.
B. An application fee for an exception to the Act shall be $1,000.
C. The renewal fee for board approval of exceptions to the Act shall be $250.
Statutory Authority
§ 54.1-2510 of the Code of Virginia.
Historical Notes
Derived from VR365-01-2 § 3.3, eff. March 24, 1994.
Part III
Discipline
18VAC75-20-90. Disciplinary action against entities.
The board shall determine violations of prohibitions of the Act on the part of an entity other than a practitioner as defined in § 54.1-2410 of the Code of Virginia in accordance with the provisions of the Administrative Process Act (§ 9-6.14:1 et seq. of the Code of Virginia).
Statutory Authority
§ 54.1-2412 of the Code of Virginia.
Historical Notes
Derived from VR365-01-2 § 4.1, eff. March 24, 1994; amended, Virginia Register Volume 15, Issue 18, eff. June 23, 1999.
18VAC75-20-100. Disciplinary action against practitioners.
A. Upon receipt of an investigative report of an alleged violation of the Act by a practitioner as defined in § 54.1-2410 of the Code of Virginia, the department, on behalf of the board, shall provide a copy of the report to the appropriate regulatory board within the department as required by subdivision 13 of § 54.1-2510 of the Code of Virginia.
B. Violations of the Act by a practitioner shall be determined by the appropriate regulatory board within the department and shall be subject to disciplinary action by that board in accordance with § 54.1-2412 D of the Code of Virginia.
C. Upon closure of a case involving an alleged violation of the Act by a practitioner, the appropriate regulatory board shall provide a copy of the final order or of the letter of dismissal of the case to the board.
D. The board shall review periodically the disposition of cases involving allegations of violation of the Act by practitioners to ensure the protection of the public and the fair and equitable treatment of health professionals, as authorized by subdivision 11 of § 54.1-2510 of the Code of Virginia.
Statutory Authority
§ 54.1-2510 of the Code of Virginia.
Historical Notes
Derived from VR365-01-2 § 4.2, eff. March 24, 1994.
18VAC75-20-110. Hearings.
The provisions of the Administrative Process Act (§ 9-6.14:1 et seq. of the Code of Virginia) shall govern proceedings on questions of violations of the Act.
Statutory Authority
§ 54.1-2510 of the Code of Virginia.
Historical Notes
Derived from VR365-01-2 § 4.3, eff. March 24, 1994.
Part IV
Delegation to an Agency Subordinate
18VAC75-20-120. Decision to delegate.
In accordance with § 54.1-2400 (10) of the Code of Virginia, the board may delegate an informal conference to an agency subordinate to consider an application for an advisory opinion or an exception to the provisions of the Act.
Statutory Authority
§§ 54.1-2400 and 54.1-2412 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 23, Issue 21, eff. September 10, 2007.
18VAC75-20-130. Criteria for delegation.
Applications that may be delegated shall be those approved by the chairman and executive director of the board.
Statutory Authority
§§ 54.1-2400 and 54.1-2412 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 23, Issue 21, eff. September 10, 2007.
18VAC75-20-140. Criteria for an agency subordinate.
A. An agency subordinate authorized by the board to conduct an informal conference may include current or past board members and professional staff or other persons deemed knowledgeable by virtue of their training and experience in the organizational structure of entities providing the health care services identified in the application.
B. The board shall delegate to the executive director the selection of the agency subordinate who is deemed appropriately qualified to conduct a conference based on the qualifications of the subordinate and the type of case being heard.
Statutory Authority
§§ 54.1-2400 and 54.1-2412 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 23, Issue 21, eff. September 10, 2007.
Forms (18VAC75-20)
Application for an Advisory Opinion - Virginia Self-Referral Act (rev. 7/2013)