Pursuant to Code of Virginia § 15.2-5369, a cooperative agreement is an agreement among two or more hospitals for the sharing, allocation, consolidation by merger or other combination of assets, or referral of patients, personnel, instructional programs, support services, and facilities or medical, diagnostic, or laboratory facilities or procedures or other services traditionally offered by hospitals.
Pursuant to the Regulations Governing Cooperative Agreements (12VAC5-221-10 et seq.) at 12VAC5-221-80(H), the State Health Commissioner shall approve an application for a cooperative agreement if he finds by a preponderance of the evidence that the benefits likely to result from the proposed cooperative agreement outweigh the disadvantages likely to result from a reduction in competition.
Former State Health Commissioner Marissa J. Levine, MD, MPH, FAAFP issued the Virginia Order and Letter Authorizing a Cooperative Agreement (Virginia Order) on October 30, 2017. Similar to Ballad Health’s Certificate of Public Advantage (COPA) in the State of Tennessee, the Virginia Order provides conditional approval of Mountain States Health Alliance (MSHA) and Wellmont Health System’s (WHS) application for a cooperative agreement.
In conjunction with Code of Virginia § 15.2-5384.1 and the Regulations Governing Cooperative Agreements, the Virginia Order governs Ballad Health’s Cooperative Agreement in Virginia. Furthermore, similar to Ballad Health’s COPA in Tennessee, the Virginia Order provides Ballad Health with state action immunity from state and federal antitrust laws by replacing competition with state regulation and active supervision.