Photo Courtesy of WV Legislative Photography  Senate Majority Leader Tom Takubo admitted Tuesday he should have sought a ruling on whether he should have voted for SB 613 having possible conflicts of interest   

CHARLESTON — The majority leader of the West Virginia Senate admitted Tuesday he should have requested a ruling on whether he had a conflict of interest after voting for a bill Monday expanding exemptions to West Virginia’s certificate of need laws for hospitals. 

The Senate passed Senate Bill 613 Monday in a 21-2 vote, relating generally to certificates of need. The bill now heads to the House of Delegates.

Among other things, SB 613 would exempt hospitals from seeking certificates of need for new hospital services, defined as inpatient services. These services would include preventative, diagnostic, treatment, or rehabilitative services provided in various departments on a hospital’s campus.

Among the senators who voted for the bill Monday was Senate Majority Leader Tom Takubo, R-Kanawha. Takubo is a doctor of osteopathic medicine and co-founder of Pulmonary Associates of Charleston. He is also executive vice president for provider relations for the West Virginia University Health System (WVU Medicine).

The bill redefines a campus as “the physical area immediately adjacent to the hospital’s main buildings, other areas, and structures that are not strictly contiguous to the main buildings, but are located within 250 yards of the main building.”

Pulmonary Associates of Charleston is 176 yards from Thomas Memorial Hospital in South Charleston. Thomas applied for a certificate of need to offer pulmonary services late last year, offering $2.8 million to purchase Pulmonary Associates. Charleston Area Medical Center, which also offers pulmonary services in the region, is challenging Thomas’ request for a certificate of need and seeking a public hearing through the West Virginia Health Care Authority.

Pulmonary services are considered “ambulatory health care” facilities, which require a certificate of need from the state to operate. But SB 613 would make needing a certificate of need to offer ambulatory services unnecessary as long as the service fell within the 250-yard requirement to be part of a hospital’s campus.

Senators who believe they have a potential conflict of interest that would prevent them from voting on a bill are required under Senate Rule 43 to inquire with the Senate president whether they should vote on the bill. The Senate president or presiding officer can rule that the senator is a member of a class, meaning that the bill would affect five or more people and be directed to vote.

The House of Delegates has a similar rule (Rule 49), and lawmakers will often request a ruling on whether they should vote on a bill to put their potential conflict of interest on the record. When asked Tuesday prior to the start of the Senate floor session about the potential conflict of interest, Takubo admitted he should have sought a Rule 43 decision.

“Pulmonary Associates is a (certificate of need) holder, so technically yes I should have,” Takubo said. “Until you said it, I didn’t even think about it to be honest with you because It’s a very broad base, but I should have.”

Takubo, first elected to the Senate in 2014 and previously the chairman of the Senate Health and Human Resources Committee, became the Senate majority leader in 2019. According to a profile in West Virginia Executive magazine, Pulmonary Associates includes seven physicians and nearly 80 employees.

Last year, WVU Medicine announced that Takubo would become its executive vice president for provider relations while also maintaining his medical practice with Pulmonary Associates.

“Tom is an outstanding physician leader whose clinical experience and insights as a community-based physician will provide important direction to us as we continue to build new relationships and partnerships with external healthcare organizations and other businesses,” said Albert Wright, president and chief executive officer of WVU Medicine, in a statement last year.

Thomas Health System, including Thomas Memorial Hospital in South Charleston and St. Francis Hospital in downtown Charleston, became a full member of WVU Medicine at the end of last year. Earlier this month, Thomas and Camden Clark Medical Center, both WVU Medicine affiliates, filed a joint certificate of need with the Health Care Authority to offer cardiac surgery services at Thomas’ South Charleston campus.

WVU Medicine already offers comprehensive cardiac services throughout the state through its WVU Heart and Vascular Institute. While Camden Clark offers cardiac surgery, the joint certificate of need will allow Camden Clark to work with Thomas to operate a joint cardiac surgery program, sharing physicians and policies. The project will cost $770,000. Takubo said seeking a Rule 43 decision on whether he could vote for SB 613 didn’t occur to him.

“To be honest with you, I didn’t even think about it,” Takubo said. “I know I’m one of so many providers, but I probably should have.”

SB 613 would also remove requirements for birthing centers to receive a certificate of need similar to House Bill 2789 that passed the House on Feb. 7. West Virginia has only one birthing center, the Family Care Health Center’s OB/GYN and Birth Center on Charleston’s West Side. The bill would also allow private medical practices with at least seven locations to acquire an MRI machine without going through the certificate of need process.

Certificate of need requirements were put into State Code in 1977, making West Virginia one of 35 states with a certificate of need process. Certificate of Need rules are designed to help control health care costs and prohibit duplicative or unneeded medical services in communities.