Certificate of Need Reform

The 2019-2020 Certificate of Need legislative working group pinpointed these areas for action on CON reform:

Eliminate bureaucratic red tape by making the CON process quicker, easier, and cheaper:

    • Reduces the length of the application process from ~135 days to 60 days.
    • Reduces the paperwork required to file an application
    • Eliminates the requirement for applicants to demonstrate “economic feasibility” of projects
    • Consolidation of CON functions enables HSDA staff to expedite the process
    • Empowers HSDA to reduce applications fees by more than half by shifting revenue away from application fees

Reduce CON regulation of certain facilities and services:

    • Completely exempts economically distressed counties from CON regulation (Lake, Lauderdale, Hardeman, McNairy, Perry, Wayne, Jackson, Clay, Grundy, Bledsoe, Fentress, Morgan, Scott, Hancock, and Cocke).
    • Non-pediatric MRI services, PET Scan services, and Outpatient Diagnostic Centers (ODCs) would no longer be regulated by CON in counties with a population above 175,000 (Shelby, Davidson, Hamilton, Rutherford, Williamson, Montgomery, and Knox)
    • Mental health hospitals would no longer be subject to Certificate of Need regulation
    • Pediatric home health provides would no longer be subject to Certificate of Need regulation

Eliminate protectionist aspects of CON:

    • States explicitly that competitor opposition shall not be considered a veto of a project
    • Eliminates frivolous appeals by competitors
    • Limits opposition to competitors within a 35-mile radius of a proposed project
    • Opponents of an application must now disclose the grounds of their opposition to the applicant before the application is heard by the HSDA Board
    • If a CON-holder is not providing the services authorized by their CON for 12 consecutive months, the CON shall be voided

Create greater regulatory flexibility:

    • Providers who need to relocate a small distance without changing their service area may now get approval without having to obtain a new CON
    • Existing facilities would be able to increase and redistribute their acute, psychiatric, and rehabilitation beds without CON regulation
    • Home health agencies no longer have to obtain a CON to relocate their primary office within their service area

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