The Va. Code requires COPN approval for “[a]ny capital expenditure of $15 million or more, not defined as reviewable in subdivisions 1 through 7 of this definition, by or on behalf of a medical care facility...[t]he amounts specified in this subdivision shall be revised effective July 1, 2008, and annually thereafter to reflect inflation using appropriate measures incorporating construction costs and medical inflation.” 32.1-102.1 (emphasis added).  In order to comply with the Va. Code, the Virginia Department of Health should amend the proposed fast track rule to state that the revised thresholds will become effective annually, on July 1.  The proposed rule should also be amended to require that each year the revised thresholds be published in the General Notices section of the Virginia Register and posted to the Department’s website by July 1.