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Virginia Administrative Code
12/7/2025

Chapter 50. Regulations Governing Practitioner Self-Referral

Part I
General Provisions

18VAC76-50-10. 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 that licenses or certifies the practitioner.

"Committee" means an informal conference committee of a regulatory board.

"Department" means the Department of Health Professions.

"Director" means the Director of the Department of Health Professions.

Statutory Authority

§§ 54.1-2410 and 54.1-2505 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 42, Issue 5, eff. November 19, 2025.

Part II
Advisory Opinions and Exceptions

18VAC76-50-20. 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 department. 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 leases, contracts, and organizational documents; 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 within it is true and correct.

C. The application shall be reviewed for completeness, and the department may request such other additional information or documentation the department 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 department shall notify the practitioner or entity that the department will consider the practitioner or entity's request.

E. At the conclusion of an informal conference, the department shall issue an advisory opinion to the practitioner or entity.

Statutory Authority

§§ 54.1-2412 and 54.1-2505 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 42, Issue 5, eff. November 19, 2025.

18VAC76-50-30. 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 department. 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; and

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 department 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 department shall notify the applicant that the department will consider the request.

E. At the conclusion of an informal conference, the department shall issue a decision regarding the request for an exception to the applicant.

F. Exceptions to the Act shall be valid for a period of no more than five years.

G. 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

§§ 54.1-2412 and 54.1-2505 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 42, Issue 5, eff. November 19, 2025.

18VAC76-50-40. 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

§ 54.1-2505 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 42, Issue 5, eff. November 19, 2025.

Part III
Discipline

18VAC76-50-50. Disciplinary action against entities.

The department 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 (§ 2.2-4000 et seq. of the Code of Virginia).

Statutory Authority

§§ 54.1-2412 and 54.1-2505 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 42, Issue 5, eff. November 19, 2025.

18VAC76-50-60. 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 director shall provide a copy of the report to the appropriate regulatory board.

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 regulatory 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 director.

D. The director 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.

Statutory Authority

§§ 54.1-2412 and 54.1-2505 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 42, Issue 5, eff. November 19, 2025.

18VAC76-50-70. Decision to delegate.

The director 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

§§ 54.1-2412 and 54.1-2505 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 42, Issue 5, eff. November 19, 2025.

18VAC76-50-80. Criteria for an agency subordinate.

An agency subordinate authorized by the director to conduct an informal conference may include current or past members of regulatory boards 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.

Statutory Authority

§§ 54.1-2412 and 54.1-2505 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 42, Issue 5, eff. November 19, 2025.

Forms (18VAC76-50)

Application for an Exception to the Prohibitions of the Virginia Practitioner Self-Referral Act (rev. 9/2025)

Application for an Advisory Opinion - Virginia Self-Referral Act (rev. 9/2025)

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