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Lawmakers tackle streamlining CON process – again

by Evan Belanger -- Birmingham Business Journal

The Alabama Legislature is again attempting to streamline the state’s criticized certificate of need review process, which controls the expansion of health care facilities statewide.

In a bill filed Feb. 21, Rep. Mary Sue McClurkin, R-Indian Springs, is again stumping for a host of tort reforms aimed at preventing abuse of the state’s CON process, which is administered by the State Health Planning and Development Agency in Montgomery.

One of 34 state CON programs nationwide, Alabama’s CON process is intended to control the cost of health care by limiting expansion of facilities to the needs of the local community. But ...

To see the rest of the story, go to http://www.bizjournals.com/.

New Hampshire CON Legislation in the News

Review board would stay, change
Panel determines need for services

By Annmarie Timmins -- CONCORD MONITOR

A House committee voted unanimously yesterday to save but change a state review board that decides whether new hospitals can build in the state and whether existing ones can expand.

The same committee will take up perhaps a trickier question tomorrow: Should an out-of-state specialty cancer hospital be allowed to skip this new and improved review board?

The state's existing certificate of need board has long been criticized as a barrier to competition, and the initial bill before the committee sought to eliminate the board.

For the rest of the story, go to http://www.concordmonitor.com/.

Bill could divert funds from hospital budgets

 By Kristin Yu -- THE DARTMOUTH

House Bill 1642-FN, which would exempt for-profit cancer treatment centers in the state of New Hampshire from state regulatory procedures and taxes to which existing hospitals are subject, is currently being debated in the New Hampshire House of Representatives. The bill has the potential to tilt the playing field unfairly in favor of for-profit cancer treatment centers, Dartmouth-Hitchcock Medical Center Interim Director of Communications Rick Adams said. Subversion of the established legal channels for health care facilities in New Hampshire by for-profit “destination cancer hospitals” is fundamentally unfair, Adams said.

HB 1642 applies directly to for-profit cancer treatment centers such as the facility that the Cancer Treatment Centers of America hopes to establish in southern New Hampshire. Such centers would be exempt from needing state Certificate of Need board approval to construct new facilities and would not be subject to paying the Medicaid Enhancement Tax if the bill were passed.

For the rest of the story, go to http://thedartmouth.com/.

Specialty Hospitals Get A Favorable Vote

By Rachel Gotbaum -- NEW HAMPSHIRE NEWS

The House Health and Human Services Committee has sent an amended bill allowing not just Cancer Specialty Hospitals but all specialty hospitals to bypass the Certificate of Need process. All other hospitals in the state must go in front of the CON board to gain approval for new or expanded services.

Rep. Lynn Blakenbeker, Republican of Concord, voted in favor of the bill.

"We as a state should be encouraging businesses all kinds to come into the state especially when it comes to specialty healthcare treatment we should be offering all options," she says.

For the rest of the story, go to http://www.nhpr.org/.

 

CON Board would expand to cover Doctors

By Grant Bosse -- NEW HAMPSHIRE WATCHDOG.ORG

Annmarie Timmins reports in the Concord Monitor that a House Committee has decided that the way to address the failure of the Certificate of Need Board to control health care costs is to give the CON Board even more power to limit health care supply.

The board would also have an expanded charge under the proposed legislation: Members would have to consider the cost of medical procedures and whether new facilities or equipment would improve health outcomes and increase overall health care costs in the state.

It would work with its existing $500,000 budget. And under the proposed legislation, the certificate of need board would be eliminated in 2017 unless lawmakers at that time decided to extend it.

For the rest of the story, go to http://newhampshire.watchdog.org/.

 

Destination hospital bill misses the mark

Unfair advantage for out-of-state firm

By Steve Ahnen -- CONCORD MONITOR

State Rep. Marilinda Garcia's recent column, "Hospital plan improves business climate" (Monitor Opinion page, Feb. 18) misses the mark on a number of fronts. Her legislation, House Bill 1642, would create a special exemption from laws to which all other hospitals in New Hampshire must adhere. How does giving preferential treatment to some at the expense of others improve the business climate for all hospitals in New Hampshire?

The state budget that was adopted last June that cut more than $250 million in Medicaid payments to hospitals has resulted in the loss of over 1,200 jobs in hospitals across New Hampshire and limits on access to services for Medicaid patients. But Garcia's bill would only make matters worse for New Hampshire's existing hospitals.

For the rest of the story, go to http://www.concordmonitor.com/.

Sunset CON in New Hampshire?

Certificate Of Need--Is It Still Needed?

By RACHEL GOTBAUM -- NHPR / NEW HAMPSHIRE NEWS

New Hampshire lawmakers are proposing a law that would do away with the Certificate of Need process. This is a state requirement for hospitals and other healthcare facilities that want to expand or establish new medical facilities. The aim of CON is to keep redundant healthcare out of the system.

That's why Rep. Cindy Rosenwald, D-Nashua, opposes the bill. She says without controls placed on new medical services, costs will rise. She cites studies that show healthcare costs are higher in regions where more care is offered. "The more capacity you have simply the more care that will be delivered," says Rosenwald.

For the rest of the story, go to http://www.nhpr.org/.

Irrational- Do Certificate of Need Laws reduce cost or hurt patients? 

By Grant Bosse -- NEW HAMPSHIRE WATCHDOG.ORG

Summary: Certificate of Need laws, or CONs, have been set up across the country under the assumption that rationing hospital construction and expansion would limit increases in health care costs. Four decades of experience have shown that CONs do not control costs, but do provide a significant barrier to entry to innovative health care facilities and limit competition in the health care marketplace. Faced with this evidence, CON supporters have created novel arguments to justify them, but these new rationales also fall under close scrutiny. New Hampshire should end its thirty-year experiment and repeal its Certificate of Need Law.

To read the entire study, go to http://www.scribd.com/.

 

House Select Committee on Certificate of Need Process Takes Action

by Poyner Spruill LLP - JDSUPRA

The House Select Committee on the Certificate of Need (CON) Process and Related Hospital Issues recently began deliberating the wide-ranging issues raised by interested parties – primarily hospitals and hospital-based health care systems - in public hearings that took place across the state this past Fall.

The committee’s January 19 meeting was the first of several scheduled meetings aimed at considering suggestions for potential modifications to North Carolina’s CON Law. Proposed changes under consideration include increases to many of the monetary thresholds in the law which some have contended are outdated and too low.

The committee voted to recommend the following changes to existing CON law:

For the rest of the story, go to http://www.jdsupra.com/.

Certificate of Need Reform (New York)

by The Editorial Team -- NEW YORK HEALTH CARE BLOG

Earlier this month certain Certificate of Need (CON) reforms went into effect. In addition to these reforms, there is an effort within the Public Health and Health Planning Council (PHHPC) of the New York State Department of Health (DOH) to realize further reform to the CON process.

Presently effective reforms include: (1) the recently implemented New York State Electronic Certificate of Need System (NYSE-CON) which became mandatory on January 12; and (2) the elimination of certain construction applications from the CON process which became effective on January 20. Accordingly, going forward all Limited Review and CON applications must be submitted electronically via NYSE-CON as DOH is no longer accepting paper applications.  Further, the following types of construction projects by a hospital possessing a valid operating certificate no longer require CON submission and PHHPC approval:

1. Routine repair or maintenance (regardless of cost);
2. Non-clinical infrastructure projects regardless of cost, including but not limited to, replacement of heating, ventilating and air conditioning systems, roofs, fire alarm and call bell systems, parking lots and elevators; and
3. One-for-one equipment replacement, regardless of cost (including replacement of old equipment with more current technology).

For the rest of the story, go to http://blog.harrisbeach.com/.

New hospital certificate of need being presented in Jefferson City

by Staff reports -- Chillicothe Constitution-Tribune

Hospital and city officials were in Jefferson City (on January 9) in support of the hospital’s presentation of its certificate of need for constructing a new hospital in Chillicothe.

A delegation of between 20 and 30 people were making the trip. The presentation was to be made to a committee of elected and appointed individuals, and local officials said they were optimistic that they will receive approval before leaving the state Capitol.The group will make its presentation, and the committee will then render a decision as to whether construction should be approved.

“We fully expect approval rendered on Monday,” said Matt Wenzel, Hedrick Medical Center CEO. “There is no reason to believe that we will not get approved. We are very confident that we have made a strong case for approval and swift execution thereafter.”

A report of the day’s events, as well as an update regarding construction of a new hospital, will be presented during a workshop of the Chillicothe City Council, beginning at 5:30 p.m. Tuesday, in the conference room at City Hall.

The hospital update workshop will be followed by the regular city council meeting at 6:30 p.m. in the council chambers at City Hall (see related story).

http://healthychillicothemo.org/

(Editorial Note: this proposed "replacement" hospital, reduced from 49 to 25 acute care beds to be a mile from the existing facility, was unanimously approved)

Patients First puts three-bed hospital in Washington, Mo., on hold

by E.B. Solomont - St. Louis Business Journal

Construction of a controversial three-bed hospital in Washington, Mo., has been placed on hold as its developer, the physician group Patients First, negotiates possible integration with a larger health system.

The project is on hold during a 110-day exclusive and confidential negotiating period with SSM Health Care-St. Louis that was announced Sept. 21, according to Patients First spokeswoman Cara Knox. “It is our intention to keep quality health care options local for the patients and families of our community,” she said in an email.

Patients First, led by CEO Joseph Gubbels, got permission from state health planners to build the three-bed hospital last fall, when the group successfully petitioned the Missouri Health Facilities Review Committee (MHFRC) to build without a Certificate of Need (CON) since the project fell under the $1 million CON threshhold. Mercy vehemently opposed the proposed hospital, to be built close to its Mercy Hospital Washington. The Patients First hospital was to be completed by the end of this year.

Facing changes in health care, Patients First announced layoffs this summer and put itself on the market for integration with a larger health system.

For the rest of the story, go to http://www.bizjournals.com/.

'Certificate of need' program challenged

by Renee Dudley -- The Post and Courier

South Carolina uses the "certificate of need" program to decide which medical facilities should be built. The exercise is intended to ensure that areas have enough hospitals without duplicating services.

The program has been criticized by an independent, non-partisan group -- the Center for Studying Health System Change. The group this year said the "certificate of need" program can be "highly subjective" and is "influenced heavily by political relationships … rather than policy objectives."

State certificate of need officials approved two proposals to build hospitals in Berkeley County in June 2009. Trident Health System won approval to add a 50-bed hospital to its network in Moncks Corner. Roper St. Francis Healthcare won approval to permanently transfer 50 beds from its downtown hospital to Goose Creek.

For the rest of the story, go to http://www.postandcourier.com/.

State regulators approve certificate for new Poplar Bluff hospital site

Daily American Republic -- Southeast Missourian

JEFFERSON CITY, Mo. -- A certificate of need for Poplar Bluff Regional Medical Center to build its new hospital at the Oak Grove Road site was approved Monday by the Missouri Health Facilities Review Committee during a hearing in the Capitol Building.

Committee members voted 6-0 to grant PBRMC's request to relocate from Route PP to a 62-acre site on the south side of Oak Grove Road between Bypass 67 and Shelby Road.

PBRMC plans to construct a seven-story hospital with 250 private beds. The estimated construction cost is around $170 million. Construction is expected to take three years.

For the rest of the story, go to http://www.semissourian.com/.

For even more detail, go to http://www.careforpoplarbluff.com/.

Committee to Consider Reforming N.C. Certificate of Need Law

by Barton C. Walker -- North Carolina Healthcare Report

Last week, NC Speaker of the House Thom Tillis appointed Rep. Fred Steen (Rowan) and Rep. John Torbett (Gaston) to lead the new "House Select Committee on Certificate of Need (CON) and Hospital Related Issues." This Committee was recently formed to examine North Carolina's Certificate of Need laws.

In particular, the Committee will be reviewing the transparency and fairness of the current process. Advocates on both sides of the CON issues have long debated the law's impact on cost and supply of healthcare as well as overall competition among providers in the state.

This is a significant development for all healthcare providers who do business in North Carolina. Critics of the CON law have long called for an overhaul or elimination of the existing requirements. Proponents have taken the position that limiting supply can help control healthcare costs.

For the rest of the story, go to http://www.carolinashealthcarelaw.com/.

A related press release is available at http://www.wncchoice.com/.