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Certificate of Need: State Health Laws and Programs

Updated: April 30, 2009; reposted November 4, 2009

Certificate of Need (C.O.N.) programs are aimed at restraining health care facility costs and allowing coordinated planning of new services and construction. Laws authorizing such programs are one mechanism by which state governments seek to reduce overall health and medical costs. Many "CON" laws initially were put into effect across the nation as part of the federal "Health Planning Resources Development Act" of 1974. Despite numerous changes in the past 30 years, about 36 states retain some type of CON program, law or agency as of mid-2008.

TABLE OF CONTENTS
- Pro and Con views
- CON Programs
- Regulated service, by state
- CON Laws, 2009
- CON legislation, 05-06 | 2007-08
- Resources & reports

HISTORY

In 1964, New York became the first state to enact a statute granting the state government power to determine whether there was a need for any new hospital or nursing home before it was approved for construction. Four years later the American Hospital Association expressed an interest in Certificate of Need laws. The AHA started a national campaign for states to generate their own CON laws. By 1975, 20 states had enacted CON laws; by 1978, 36 states had enacted them.

The 1974 federal Act required all 50 states to have a structures involving the submission of proposals and obtaining approval from a state health planning agency before beginning any major capital projects such as building expansions or ordering new high-tech devices. Many states implemented CON programs in part because of the incentive of receiving CON federal funds.

Finance health

The federal mandate was repealed in 1987, along with its federal funding. In the decade that followed, 14 states discontinued their CON programs. However, 36 states currently maintain some form of CON program, and even the 14 that repealed their state CON laws still retain some mechanisms intended to regulate costs and duplication of services. Puerto Rico and the District of Columbia also have CON programs.

States that have retained CON programs currently tend to concentrate activities on outpatient facilities and long-term care. This is largely due to the trend toward free-standing, physician owned facilities that constitute an increasing segment of the health-care market.

In some states, the debate regarding the future of CON remains intense. For example Georgia spent 18 months examining the role of CON, with a final Commission report issued in December 2006. See GA Final CON Report by the State Commission on the Efficacy of the Certificate of Need Program online. They state, "The Commission has been able to reach consensus on a number of ways to improve upon Georgia’s Certificate of Need Program. However, sharp disagreement remains with regard to a number of areas of regulation, most notably, regulation of ambulatory surgery centers and free-standing imaging centers." [ Adobe PDF PDF, 267 pages]

INTENT AND STRUCTURE OF CON

The basic assumption underlying CON regulation is that excess capacity (in the form of facility overbuilding) directly results in health care price inflation. When a hospital cannot fill its beds, fixed costs must be met through higher charges for the beds that are used. Bigger institutions have bigger costs, so CON supporters say it makes sense to limit facilities to building only enough capacity to meet actual needs.

CON programs originated to regulate the number of beds in hospitals and nursing homes, and to prevent overbuying of expensive equipment. Mandatory regulation through health planning agencies determined the most urgent health care needs, contributed to solutions for these needs, and attempted to manage the fluctuations in prices often caused by a competitive market. The idea was that new or improved facilities or equipment would be approved based only on a genuine need in a community. Statutory criteria often were created to help planning agencies decide what was necessary for a given location. By reviewing the activities and resources of hospitals, the agencies made judgments about what needed to be improved. Once need was established, the applicant organization (corporation, not-for-profit, partnership or public entity) was granted permission to begin a project. These approvals generally are known as "Certificates of Need."

C.O.N. SUPPORTERS' VIEWS

C.O.N. OPPONENTS' VIEWS

Advocates of CON programs say that health care cannot be considered as a “typical” economic product. They argue that many “market forces” do not obey the same rules for health care services as they do for other products. In support of this argument, it is often pointed out that, since most health services (like an x-ray) are “ordered” for patients by physicians, patients do not “shop” for these services the way they do for other commodities. This makes hospital, lab and other services insensitive to market effects on price, and suggests a regulatory approach based on public interest.

The American Health Planning Association (AHPA) is the professional group of state agencies responsible for regulation and planning. They identify three factors that suggest the need for CON programs. The primary argument is that CON programs limit health-care spending. CONs can promote appropriate competition while maintaining lower costs for treatment services. The AHPA argues that by controlling construction and purchasing, state governments can oversee what expenditures are necessary and where funds will be used most effectively. This helps eliminate projects that detract attention from more urgent and useful investments and reduces excessive costs. A study conducted by the "big-three" automakers claims lower health care costs in CON states then in non-CON states. AHPA also asserts that CONs have a valuable impact on the quality of care. When facilities and equipment are monitored, hospitals and other treatment centers can acknowledge what sort of services are in demand and how effectively patients are being taken care of.

Additionally, according to supporters, the programs distribute care to areas that could be ignored by new medical centers. CON programs are a resource for policymakers. CON regulations are described as a reliable way to implement basic planning policies and practices, and aid in distributing health care to all demographic areas. The CON process can call attention to areas in need because planners can track and evaluate the requests of hospitals, doctors and citizens and see which areas are underserved or need to be improved and developed.

CON programs also have been subject to wide criticism. To start, opponents argue that "it is not clear that these state-sponsored programs actually controlled health care costs." For example, by restricting new construction, CON programs may reduce price competition between facilities, and may actually keep prices high. Barriers to new building are seen as unfair restrictions, sometimes by both existing facilities and their potential new competitors. There is little direct broad proof that overcapacity or duplication leads to higher charges. In 2004 the Federal Trade Commission (FTC) and the Department of Justice both claimed that CON programs actually contribute to rising prices because they inhibit competitive markets that should be able to control the costs of care and guarantee quality and access to treatment and services. (1)

Some opponents felt that changes in the Medicare payment system (such as paying hospitals according to Diagnostic Related Groups – “DRGs”) would make external regulatory controls unnecessary, because health care organizations would be more subject to market pressures. Some pointed out that the CON programs are not consistently administered. A 'flexible' program could allow development, to the dismay of competitors. A 'restrictive' program could limit competition, with the same effect. Many argued that health facility development should be left to the economics of each institution, in light of its own market analysis, rather than being subject to political influence.

Some evidence suggests that lack of competition paradoxically encouraged construction and additional spending. Some opponents of CON programs believe an open health care market, based on quality rather than price, might be the best principle for containing rising costs. Proponents of CON programs disagree. This debate rests on the same arguments as many other “Regulated market” vs. “Open market” discussions.

In theory, Certificates of Need are granted based on objective analysis of community need, rather than the economic self-interest of any single facility. However, opponents of CON programs claim that the programs have not worked this way. They cite examples in which CONs were apparently granted on the basis of political influence, institutional prestige or other factors apart from the interests of the community. Furthermore, it is sometimes a matter of debate what sort of development is actually in the community’s interest, with people of good will sharply divided on how to determine this.

Other Approaches

Many approaches have been tried to controlling health care costs, including government and industry regulation, provider incentives, “free market” incentives and educational efforts. Some of these include:

Limitations on physician referrals to facilities in which they or a family member have a financial interest (so-called "Stark regulations").
Supervision by insurers to make sure a treatment request is necessary (precertification, concurrent or retrospective medical necessity review).
Prepayment for insured or covered services (“managed care”)
Fixed payments for defined services (“Information Individual Programs DRGs”- uniform Diagnostic-Related Groups)
Providing information to patients about the costs and necessity of certain tests and treatment (includes "transparency" and disclosure programs)
Providing information to patients about the quality of and outcomes at certain medical facilities.

CON In the News

Tenn.: "Opinions differ on whether CON process raises or lowers health care costs" - Times-News 4/26/08.
Michigan: "States limit Costly Sites For Cancer Radiation" - NY Times, April 30, 2008.
Iowa: Rural Hospital may be exempted from CON - Iowa lawmakers quietly passed a bill in the final hours of the 2008 legislative session that would allow most of the state's hospitals to bypass public approval for the construction of new facilities. The bill eliminates a requirement for Iowa's 82 small, rural hospitals to submit to public hearings and obtain state approval before relocating to newly constructed replacement hospitals. "One of the biggest contributors to the growth in health care costs is the rapid expansion of these facilities," Hatch said. "This legislation allows 80 or so Iowa hospitals to replace their hospital without any citizen input and without any justification of the cost. It's just another reason why our health care costs are going up." DesMoine Register, 5/4/08.

Footnotes:

1. The Federal Trade Commission, Department of Justice, Improving Health Care: A Dose of Competition (Washington D.C.: FTC, DOJ, 2004) 361 pages Adobe PDF PDF.

STATES WITH CON PROGRAMS

Map of 50 states with or without CON programs

State/District with CON Programs	Dates of Programs	Certificate of Need Contact Information	Individual CON Websites
Alabama	1977-present	James E. Sanders, Deputy Director Phone: 334-242-4103; Fax: 334-242-4113	http://www.shpda.state.al.us News Article: AL: Bill introduced in Alabama House that would abolish the Certificate of Need process for health services 2/12/09.
Alaska	1976-present	David Pierce, CON Coordinator Phone: 907-465-3001; Fax: 907-465-4101	Alaska's Certificate of Need Program
Arizona	1971-1985		No CON Program; see planning agency below
Arkansas	1975-present	Deborah Frazier, Director Phone: 501-661-2509; Fax:501-661-2399	http://www.arhspa.org
California	1969-1987		No CON Program; see planning agency below
Colorado	1973-1987		No CON Program; see planning agency below
Connecticut	1973-present	Kimberly Martone, Director Phone: 860-418-7029 Fax: 860-418-7053	Connecticut's Certificate of Need Program
Delaware	1978-present	Francis Osei-Afriyie, Management Analyst Phone: 302-741-2960; Fax: 302-741-2970	Delaware's Certificate of Public Review Program
District of Columbia	1968-present	Amaha Selassie, Chief, Project Review Phone: 202-442-5875; Fax: 202-442-4824	DC Certificate of Need Website
Florida	1972-present	Jeff Gregg, Bureau Chief Phone: 850-922-8672; Fax: 850-488-6964	Florida Licensing and Certification
Georgia	1979-present	Clyde Reese, III, Esq., Executive Director Phone: 404-657-7198; Fax: 404-656-0654	Georgia's Certificate of Need Program
Hawaii	1974-present	Ronald E. Terry, Administrator Phone: 808-587-0788; Fax: 808-587-0783	Hawaii's website for Certificate of Need
Idaho	1980-1983		No CON Program; see planning agency below
Illinois	1974-present	Jeffrey Mark, Health Planning Board Phone: 217-783-3516; Fax: 217-785-4308	http://www.idph.state.il.us/about/hfpb.htm
Indiana	1980-1996, 1997-1999		No CON Program; see planning agency below
Iowa	1977-present	Barb Nervig, Program Manager Phone: 515-281-4344; Fax: 515-281-4958	http://www.idph.state.ia.us/do/cert_of_need.asp
Kansas	1972-1985		No CON Program; see planning agency below
Kentucky	1972-present	Shane O'Donley, Division Director Phone: 502-564-9589; Fax: 502-564-0302	http://chfs.ky.gov/ohp/con
Louisiana	1991-present	James Taylor, Facility Need Review Mgr. Ph: 225-342-3881; Fax: 225-342-3893	http://www.dhh.state.la.us/
Maine	1978-present	Phyllis Powell, Director Phone: 207-287-9338; fax: 207-287-5807	Maine Certificate of Need Procedures Manual \| Maine Government Website
Maryland	1968-present	Paul Parker, Acting Chief Phone: 410-764-3261; Fax: 410-358-1311	Maryland Certificate of Need Program
Massachusetts	1972-present	Joan Gorga, Acting Director Phone: 617-753-7340; Fax: 617-753-7349	http://www.state.ma.us/dph/dhcq/don.htm
Michigan	1972-present	Larry Horvath, Manager Phone: 517-241-3343; Fax: 517-241-2962	http://www.michigan.gov/con The Michigan Certificate of Need Program (68 pp)- an in-depth analysis by CRC-Michigan
Minnesota	1971-1985		No CON Program; see planning agency below
Mississippi	1979-present	Rachel Pittman, Chief, P&RD Phone: 601-576-7874; Fax: 601-576-7530	Mississippi Certificate of Need Program
Missouri	1979-present	Thomas Piper, Director Phone: 5573-751-6043; Fax: 573-751-7894	www.dhss.mo.gov/con "Certificate of Need: Protecting the Public Interest" Slides by MO CON Program. 2006
Montana	1975-present	Kathy Lubke, Director Phone: 406-444-9519, Fax: 406-444-1742	Administrative Rules of Montana CON
Nebraska	1979-present	Claire Titus, Section Program Manager Phone: 402-471-4963; Fax: 402-471-3577	http://www.hhs.state.ne.us/crl/need.htm
Nevada	1971-present	Lynn O'Mara, Director Phone: 775-684-4169; Fax: 775-684-4156	http://www.health2k.state.nv.us/vs/letter.htm
New Hampshire	1979-present	Cynthia Carrier, Managing Analyst Phone: 603-271-4606; Fax: 603-271-4141	http://www.nhha.org/nhha/state_law/con.php
New Jersey	1971-present	John Calabria, Director Phone: 609-292-8773; Fax: 609-292-3780	(none) http://www.state.nj.us/health/forms/cn-7_7a.pdf (application only)
New Mexico	1978-1983		No CON Program; see planning agency below
New York	1966-present	Christopher Delker, Program Research Sp. Phone: 518-402-0966; Fax: 518-402-0971	http://www.health.state.ny.us/nysdoh/cons/index.htm
North Carolina	1978-present	Lee Hoffman, Chief Phone: 919-855-3873; Fax: 919-733-8139	http://facility-services.state.nc.us/
North Dakota	1971-1995		No CON Program
Ohio	1975-present	Christine Kenney, CON Director Phone: 614-644-3325; Fax: 614-752-4157	Ohio CON webpage
Oklahoma	1971-present	Darlene Simmons, Director Phone: 405-271-9444; Fax: 405-271-7360	Oklahoma CON Abstract
Oregon	1971-present	Jana Fussell, CON Coordinator Phone: 503-731-4320; Fax: 503-731-4078	Oregon CON Webpage
Pennsylvania	1979-1996		No CON Program; see planning agency below
Puerto Rico	1975-present		Consultant CON webpage
Rhode Island	1968-present	Michael K. Dexter, Chief, Office of Health Systems Development Phone: 410-222-2788; Fax: 410-273-4350	http://www.health.ri.gov/hsr/healthsystems/index.php
South Carolina	1971-present	Beverly B. Patterson, Director Phone: 803-545-4200; Fax: 803-545-4570	http://www.scdhec.gov/hr/cofn/
South Dakota	1972-1988		No CON Program; see planning agency below
Tennessee	1973-present	Melane M. Hill, Executive Director Phone: 615-741-2364; Fax: 615-741-9884	http://tennessee.gov/hsda/cert_need_sum.html
Texas	1975-1985		No CON Program; see planning agency below
Utah	1979-1984		No CON Program; see planning agency below
Vermont	1979-present	Jennifer Garson, CON Specialist Phone: 802-828-2900; Fax: 802-828-2949	Vermont CON program
Virginia	1973-present	Erik Bodin, Director Phone: 804-367-2126; Fax: 804-367-2206	http://www.cvhpa.org/COPN.htm
Washington	1971-present	Janis Sigman, Manager Phone: 360-236-2956; Fax: 360-236-2901	Washington CON program
West Virginia	1977-present	Dayle Stepp, CON Director Phone: 304-558-7000; Fax: 304-559-7001	http://www.hcawv.org/CertOfNeed/conHome.htm
Wisconsin	1977-1987, 1993-present	Neal Brandt, Phone: 608-267-0243; Fax: 608-264-7720	Wisconsin Resource Allocation Program
Wyoming	1977-1989		No CON Program; see planning agency below

HEALTH PLANNING AGENCIES IN STATES WITHOUT CURRENT C.O.N. PROGRAMS

State	Dates of CON law	Planning Agency & Contacts
Arizona	1971-1985	Patricia Taranga, Chief Phone: 602-542-1219; Fax: 602-542-2011 ptargan@hs.state.as.us	No CON Program
California	1969-1987	Jonathan M. Teague, Manager Phone: 916-322-2814; Fax: 916-324-9242 jteague@oshpd.state.ca.us	No CON Program
Colorado	1973-1987	Alyson Shupe, Chief, Health Statistics Phone: 303-692-2470; Fax: 303-782-5576 alyson.shupe@state.co.us	No CON Program
Idaho	1980-1983	Jane Smith, Chief Phone: 208-334-5976; Fax: 208-332-7360 smithj2@idhw.state.id.us	No CON Program
Indiana	1980-1996, 1997-1999	Tom Reed, Public Health Administrator Phone: 317-233-7541; Fax: 317-233-7157 treed@isdh.state.in.us	No CON Program
Kansas	1972-1985	Richard J. Morrissey, Deputy Director Phone: 785-296-1343; Fax: 785-296-1562 rmorriss@kdhe.state.ks.us	No CON Program
Minnesota	1971-1985	Sheila Brunelle, Principal Planner Phone: 651-282-3853; Fax: 651-297-5808 sheila.brunelle@health.state.mn.us	No CON Program
New Mexico	1978-1983	Kristine Jacobus, Deputy Director Phone: 505-424-3200; Fax: 505-424-3222 kristine.jacobus@hpc.state.nm.us	No CON Program
North Dakota	1971-1995	Gary Garland, Director Phone: 701-328-2894; Fax: 701-328-1890 ggarland@state.nk.us	No CON Program
Pensylvania	1979-1996	Michelle S. Davis, Deputy Secretary Phone: 717-783-8804; Fax: 717-772-6959 msdavis@state.pa.us	No CON Program
South Dakota	1972-1988	Doneen Hollingsworth, Secretary Phone: 605-773-3361; Fax: 605-773-5683 doneen.hollinsgworth@state.sd.us	No CON Program
Texas	1975-1985	Connie Turney, Project Director Phone: 512-458-7261; Fax: 512-458-7344 connie.turney@dshs.state.tn.us	No CON Program
Utah	1979-1984	David Sundwall, MD Executive Director Phone: 801-538-6111 dnsundwall @utah.gov	No CON Program
Wyoming	1977-1989	Morris Gardner, Senior Advisor Phone: 307-777-7656; Fax: 307-777-7439 mgardn@state.wy.us	No CON Program

Contact information obtained from American Health Planning Association National Directory, 2007 edition.

FACILITIES AND SERVICES REGULATED BY C.O.N.

Regulated Services	States, Districts & Commonwealth
Acute Hospital Beds	AL, AK, CT, DE, FL, GA, HI, IL, KY, ME, MD, MI, MS, MO, NV, NH, NJ, NY, NC, RI, SC, TN, VT, VA, WA, WV, DC, PR
Air Ambulance	AK, CT, HI, ME, MA, MI, NC, TN, VT
Ambulatory Surgical Centers (ASC)	AL, AK, CT, DE, GA, HI, IL, IA, KY, ME, MD, MA, MI, MS, MT, NV, NH, NY, NC, RI, SC, TN, VT, VA, WA, WV, DC, PR
Assisted Living (also see Residential Care, below)	AK
Behavioral Health	WV
Birthing Centers	DE
Burn Care	AK, CT, FL, HI, IL, ME, MD, NJ, NY, NC, VT, WA, WV
Business Computers	CT, VT, WV
Cardiac Catheterization	AL, AK, CT, DE, GA, HI, IL, IA, KY, ME, MD, MI, MS, MO, NH, NJ, NY, NC, RI, SC, TN, VT, VA, WA, WV, DC
Computed Tomography (CT) Scanners	AK, CT, GA, HI, ME, MI, MO, NH, NY, NC, RI, TN, VT, VA, DC, PR
Gamma Knives	AL, AK, CT, GA, HI, IL, ME, MA, MI, MS, MO, NY, NC, RI, SC, VT, VA, WV, DC.
Home Health	AL, AK, AR, GA, HI, KY, MD, MS, MT, NJ, NY, NC, SC, TN, VT, WA, WV, DC
Hospice	AL, AK, AR, CT, FL, IL, KY, MD, MS, NV, NY, NC, OH, TN, VT, WA, WV, PR
Hospital (also see Acute Hospital, above)	MI, MO
Intensive Care	NC
Intermediate Care Facilities/Mental Retardation (ICF/MR)	AR, FL, GA, HI, IL, IA, KY, LA, ME, MD, MS, MO, MT, NV, NJ, NY, NC, OK, SC, TN, VT, VA, WV, WI, PR
Long Term Acute Care (LTAC)	AL, AK, CT, DE, FL, GA, HI, IL, KT, ME, MD, MA, MI, MS, MO, NV, NH, NJ, NY, NC, RI, SC, TN, VT, VA, WA, WV, DC, PR
Lithotripsy	AL, AK, CT, DE, GA, HI, KY, ME, MA, MI, MS, MO, NH, NY, NC, SC, TN, VT, VA, WV, DC.
Long Term Care	AL, AK, AR, CT, DE, FL, GA, HI, IL, IA, KY, LA, ME, MD, MA, MI, MS, MO, MT, NE, NH, NV, NJ, NY, NC, OH, OK, OR, RI, SC, TN, VT, VA, WA, WV, WI, DC, PR
Medical Office Buildings	CT, GA, DC
Medical Services for Indigents (MSI)	VA
Mobile Hi Technology (CT / MRI / PET, etc)	AK, CT, GA, HI, KY, ME, MI, MO, NH, NY, NC, RI, SC, VT, VA, WV, DC
Mobile Medical Services	KY
Magnetic Resonance Imaging (MRI) Scanners	AL, AK, CT, GA, HI, KY, ME, MA, MI, MS, MO, NH, NY, NC, RI, SC, TN, VT, VA, WV, DC
Neo-Natal Intensive Care	AL, AK, CT, FL, GA, HI, IL, KY, ME, MD, MA, MI, NJ, NY, NC, RI, SC, TN, VT, VA, WA, WV, DC
Obstetrics Services	AL, AK, CT, GA, HI, IL, ME, MD, NY, RI, SC, VT, VA, WA, WV, DC
Open Heart Services	AL, AK, CT, FL, GA, HI, IL, IA, KY, ME, MD, MA, MI, MS, MO, NH, NJ, NY, NC, RI, SC, TN, VT, VA, WA, WV, DC
Organ Transplants	AL, AK, CT, FL, GA, HI, IL, IA, KY, ME, MD, MA, MI, MO, NJ, NY, NC, RI, VT, VA, WA, WV, DC
Positron Emission Tomography (PET) Scanners	AL, AK, CT, DE, GA, HI, IL, IA, ME, MA, MI, MS, MO, NH, NY, NC, RI, SC, TN, VT, VA, WV, DC, PR
Psychiatric Services	AL, AK, CT, FL, GA, HI, IL, KY, ME, MD, MA, MI, MS, NH, NJ, NY, NC, OK, RI, SC, TN, VT, VA, WV, DC, PR
Radiation Therapy	AL, AK, CT, DE, GA, HI, IL, IA, KY, ME, MD, MA, MI, MS, MO, NH, NY, NC, RI, SC, TN, VT, VA, WV, DC
Rehabilitation	AL, AK, CT, GA, HI, IL, KY, ME, MD, MA, MS, MT, NE, NV, NH, NJ, NY, NC, RI, SC, TN, VT, VA, WA, WV, DC
Renal Failure/Dialysis	AL, AK, HI, IL, ME, MS, MO, NY, NC, VT, WA, WV, DC
Assisted Living & Residential Care Facilities	AK, AR, CT, GA, KY, MA, MS, MO, NJ, NY, NC, WV
Single Photon Emission Computed Tomography (SPECT)	VA
Subacute Services	AK, AR, FL, GA, HI, IL, KY, MD, NV, OK, RI, SC, TN, WA, WI, DC
Substance/Drug Abuse	AL, AK, CT, FL, GA, HI, ME, MD, MA, MS, MT, NV, NH, NY, NC, OK, RI, SC, TN, VT, VA, WV, DC
Surgery (also see Amulatory Surgical Centers)	MI
Swing Beds	AL, AK, AR, CT, GA, HI, IL, ME, MI, MS, MT, NY, NC, OR, RI, TN, VT, WA, WV, DC
Ultra-Sound	AK, CT, ME, MO, NY
Other (Not otherwise covered)	AL, AR, CT, GA, IL, KY, MD, MA, MI, NC, OK, TN, WA, WI, PR

NOTE: The categories listed above are for general information. See state-specific limitations, exceptions and requirements.

CON Online Sources & Resources:

1. http://www.ahpanet.org/articlescopn.html Articles and essays collected from American Health Planning Association

2. http://www.washingtonpolicy.org/HealthCare/PBBARNESCON.htm Opponent view of CON Program using Washington State as example.

* Federated Ambulatory Surgery Association (FASA) - trade association representing interests of Ambulary surgical centers nationwide. www.fasa.org

3. www.ftc.gov The Federal Trade Commission website

4. http://www.ahpanet.org/websites_copn.html American Health and Planning Association with other planning related websites and a list of websites for the CON programs of each state. http://www.ahpanet.org/index.html

5. http://content.healthaffairs.org/cgi/reprint/hlthaff.25.w337v1

6. http://rs6.net/tn.jsp?t=hxqahxbab.0.r8qvn8n6.uqoukvn6.124901&p=http%3A%2F%2Fwww.healthaffairs.org

7. 'Monopoly is not the Answer' an abstract of how regulations have affected the markets. Health Affairs, August 9, 2005.

8. 'Effects of Physician-Owned Limited Service Hospitals: Evidence from Arizona' an abstract. Health Affairs, October 25, 2005.

10. 'Specialty Versus Community Hospitals: What Role for the Law?' Health Affairs, August 9, 2005.

12. http://www.law.fsu.edu/journals/lawreview/issues/231/heading2

Diagnostic Imaging on Rise in Managed Care -Use of radiology imaging tests has soared in the past decade with a significant increase in newer technologies, according to a new study that is the first to track imaging patterns in a managed care setting over a substantial time period. Study results are reported in the November/December 2008, Health Affairs.

2009 - 2010 Passed Bills/Signed Laws: CON State Legislation

State/Bill/Web link/Sponsor	Descriptions of Bills/Excerpts of bill text
MD SB 1039, HB 1486 Sen. Currie Rep. Hubbard	Allows the Maryland Health Care Commission to issue an exemption from Certificate of Need and waive the requirements of the State Health Plan in order to facilitate a recommendation by the authority to relocate beds or services of all or part of a facility. Any health care entity that acquires all or part of the Prince George's County health care system shall be recognized as a merged asset system for certificate of need purposes. (filed 3/2/09; signed into law by governor* as Chapters 116 & 117, 4/14/09)*
NJ AB 3389 Assm. Barnes	The termination of provision of hospital acute care services shall not preclude the commissioner from issuing a new Certificate of Need with respect to the provision of hospital acute care services at the location to a party unrelated to the party to whom the Certificate of Need with respect to the termination of the provision of hospital acute care services was issued. (filed 10/23/08; signed into law by governor* as Chapter 2009-2, 1/15/2009*)
VA HB 1768 Rep. Dance	Exempts medical care facilities of the Department of Corrections from the definition of medical care facility for purposes of the Certificate of Need process. (filed 1/14/09; signed into law by governor* as Chapter No.67, 2/25/09*)
VA SB 1162 Sen. Watkins	Provides that when a certificate of need holder fails to satisfy the conditions of the certificate, the certificate holder shall file a plan of correction with the Department of Health; relates to methods to satisfy the certificate, which may include direct payments to a private nonprofit foundation that funds basic insurance coverage for indigents or other documented efforts to provide primary or specialized care to underserved populations. (filed 1/14/09; signed into law by governor* as Chapter 711, 3/30/09*)
VA HB 1598 Rep. Hamilton	Sets guidelines for the issuance of certificate of need by the Commissioner of Health. (filed 1/14/09; signed into law by governor* as Chapter No. 175, 3/25/09*)
VA HB 1605 Rep. Purkey	Authorizes the Commissioner of Health to accept and approve a request to amend the conditions of a certificate of need issued for an increase in beds in which nursing facility or extended care services are provided to allow such facility to continue to admit persons, other than residents of the cooperative units, to its nursing facility beds when created in connection with a real estate cooperative or offers residents a level of continuing care. (filed 1/14/09; signed into law by governor* as Chapter No. 394, 3/27/09*)
WA SB 5423 Sen. Pflug	Exempts from the certificate of need process up to a specified number of swing beds in a critical access hospital that is located in a city or town without a nursing home in the city or town limits. (filed 1/21/09; signed into law by governor* as Chapter 54, 4/10/09*)
WA HB 1926 Rep. Cody	Exempts hospice agencies from the certificate of need process if the agencies provide services designed to meet the religious or cultural needs of religious groups or ethnic minorities. (filed 2/3/09; signed into law by governor* as Chapter 89, 4/15/09*)
WV SB 321 Sen. Prezioso	Modifies certificate of need process and review; sets standards for ambulatory health care facilities not subject to certificate of review; provides that electronic health records are not subject to certificate of review; provides that nonhealth-related projects are subject to certificate of review; modifies the fee structure for certificate of review. (filed 2/20/09; signed into law by governor, 4/13/09)

2007-08 Examples of CON State Legislation (partial list only)

In February 2008 there were 195 CON bills filed, pending or resolved in 2008 sessions. The following table includes all substantive CON-related laws signed in 2008 as of September 1, in CT, DC, FL, GA, IN, LA, ME, MD, MA, NE, NH, RI, TN, UT, VT and VA. In 2007 CON laws were signed in GA, IL, IN, ME, NC, VT, VA and WA among others. The table also includes a small sample of measures filed but not passed.

State/Bill/Web link/Sponsor yellow background=enacted	Descriptions of Bills/Excerpts of bill text
AK HB 4 Rep. Lynn	Would amend the certificate of need requirements to apply only to health care facilities and nursing homes located in communities with a population of not more than 25,000 or in a community with a critical access hospital. (Filed 1/07; did not pass by end of session. Also see proposed ballot measure 07CHA3.) AK: State forms CON reform committee The state health department named 21 people from across the medical community to reform the certificate of need program. (Fairbanks Daily News-Miner, 10/18/07) AK: "Here's one way to cut health care costs, improve quality:" Other points of view, by Governor Sarah Palin, 2/14/08.
AK HB 337, SB 245 Gov. Palin, Rep. Kelly	Would repeal the certificate of need program for certain health care facilities and relating to the repeal; annuls regulations required for implementation of the certificate of need program for certain health care facilities. (Filed 1/19/08; S 245 did not pass committee 3/31/08; H 337 substituted in committee; did not pass House 3/10/08)
AK SCR 24 Senate HESS Comm.	Concurrent resolution, would establish a 15-member Joint Legislative Certificate of Need Task Force to evaluate the current program and recommending improvements to the laws relating to certificates of need. (Filed 3/4/08; did not pass House committee 4/7/08)
CT SB 559 Joint Committee on Human Services	Establishes a pilot program to provide grants in aid for the development of small house nursing homes in the state; provides additional exceptions to the nursing home bed moratorium. (Filed 02/28/2008; Passed House and Senate 05/27/2008; signed into law by governor* as Chapter 91 on 05/27/2008)*
CT SB 622 Public Health Comm	Modifies the Office of Health Care Access' current certificates of need practices; providing that each health care facility that proposes a capital expenditures for parking lots and garages, information and communications systems, physician and administrative office space, acquisition of land for nonclinical purposes and replacement of nonmedical equipments, is exempt from CON review. (Filed 3/4/08; signed into law by governor* as Act 14, 4/29/08)*
DC B 356 B 560, R 622 Councilman Catania	Amends the Health Services Planning Program Re-establishment Act of 1996; exempts non-hospital-based substance abuse treatment facilities from certificate of need requirements for a certain period. Declares the existence of an emergency, due to Congressional review, (Enacted as Chapters 137 & 250, 1/23/08)
DC B 362 Councilman Catania	Amends the Health Services Planning Program Amendment Act of 2007; sets the certificate of need application fee for Medical Homes DC projects. (Enacted, signed into law by mayor* as Act 259, 1/23/08)*
FL HB 163, SB 430, SB 960 Rep. Hays, Rep. Jones	Would exempt projects involving: (H.163) geriatric acute-care, in-patient psychiatric specialty hospital beds or (S 960) establishing certain teaching hospitals on property owned or leased by a state university from review relating to certificates of need. (Did not pass by end of 2007 session)
FL SB 2326 Senate Committees	Revises laws regarding an application for a certificate of need for a general hospital, Agency for Health Care Administration reviews and requirements for such applications, public hearings, statements of opposition, letters of intent, administrative hearings , attorney's fees, parties allowed to challenge applications and the scope of such challenges, administrative judge authority, and appeals; repeals a requirement for an architect's certification of final payment before issuance of a certificate. (Filed 03/13/2008; passed House and Senate 05/19/2008; signed into law by governor* as Chapter 29 on 05/19/2008)*
GA HB 967 Rep. Martin	Relates to exemptions from the certificate of need program, so as to exempt prisons and other secure correctional institutions of the Department of Corrections and the Department of Juvenile Justice from certificate of need requirements; provides for legislative findings. (Filed 01/17/2008; Passed House and Senate 04/09/2008; signed into law by governor* as Act 2008-390, 04/09/2008)*
GA S 60 Sen. Statton	Establishes the Georgia Trauma Commission; providing that hospitals offering or seeking to offer emergency trauma services may add additional beds or operating rooms for emergency trauma purposes without the necessity of applying for a certificate of need. (Signed into law by governor* as Chapter 14, 5/17/07)*
GA SB 433 Sen. Williams	Relates to State health planning and development; relates to certificates of need, destination cancer hospitals, perinatal services, proposed new clinical health services, health care facility annual reports to the Department of Community Health, the licensing of hospital and other health care facilities, and licensure standards on a clinical service level for hospitals and related institutions. Establishes the Certificate of Need Appeal Panel as the successor to the duties of the abolished Health Planning Review Board, as of June 30, 2008. (Filed 02/08/2008; Passed House and Senate 04/09/2008; signed into law by governor as Act 392, 04/09/2008)
HI S 2418	Would reorganize the certificate of need process by eliminating the review panel and the statewide health coordinating council and by renaming the subarea health planning councils to Regional Health Planning Councils. (Filed 1/18/08).
IL S 244, S 264 Sen. Garrett	Amends the Health Facilities Planning Act. Extends the repeal of the Act. Creates the Task Force on Health Planning Reform. Requires the Task Force to gather information and to make recommendations. Provides for updating the bed inventory and associated bed needs projections regarding medical-surgical and pediatric categories. Provides for the impact of speciality providers and ambulatory surgical centers on safety-net providers. Relates to long-term and acute-care facilities and closure. S 264 Relates to a health planning area with a demonstrated need for obstetrical service beds. (Passed Senate and House; signed into law by governor as Public Act No. 95-5, 5/31/07; S 264 was signed into law by governor as Public Act No. 95-445, 8/27/08)
IN SB 193 Sen. Miller	Comprehensive Care Bed Moratorium Extension. Cost estimate for administration, FY 2007-2009 = $750,000 annually (Signed into law by governor* as Public Law 158, 5/24/07)*
IN SB 315 Sen. Dillon	Relates to the conversion of long term care beds to comprehensive care beds. (Filed 01/10/2008; passed House and Senate 03/24/2008; signed into law by governor* as Public Law 121, 03/24/2008)*
LA HB 155 Rep. Katz	Relates to the facility need review process; adds nursing facilities to the process; changes references to community and group home beds for the "mentally retarded" to "developmentally disabled." (Filed 03/31/2008; passed House and Senate 06/21/2008; signed into law by Governor* as Chapter 341, 06/23/2008)*
LA HB1062 Rep. Mills	Extends the moratorium on licensing for methadone maintenance programs; repeals provisions requiring a study to determine the need and criteria for certification of methadone clinics; allows the department discretion to determine if there is a need for new or additional programs and to license a new or additional program if necessary. (Filed 03/31/2008; passed House and Senate 06/12/2008; signed into law by governor* as Act 166, 06/12/2008)*
ME H 1243	Makes changes to the Certificate of Need Act; provides that the nursing facility MaineCare funding pool means that limit established in accordance with requirements for nursing facility projects; relates to acquisitions of major medical equipment at a fair market price; exempts medical equipment used in a disaster or accident; regulates construction of a new health care facility; provides for a review and public hearings; relates to records, licensing and delicensing. (Filed 3/29/2007; Passed House and Senate; signed into law by governor* as Chapter 314, 6/18/2007*
ME HB 1659 a Rep. Perry	Amends the Certificate of Need Act; standardizes the date when the state must update the threshold amount for review to reflect the change in the Consumer Price Index medical index; clarifies when the Department of Health and Human Services may approve nursing facility certificate of need applications for capital expenditures for necessary renovations and improvements; provides for major medical equipment. (Filed 04/03/2008; Passed House and Senate 04/23/2008; signed into law by governor* as Chapter 681, 04/23/2008).*
MD SB 782 Sen. Zirkin	Requires a Statement of Need for developing, operating, establishing, relocating, or expanding a residential child care program; requires that, before an application is submitted or a license is granted, the Department of Human Resources or Department of Juvenile Services shall issue a statement of need to a program; requires the departments to adopt certain regulations and provide notification of certain applications. (Filed 02/05/2008; passed House and Senate 05/13/2008; signed into law by governor* as Chapter 454, 05/13/2008)*
MA S 2863 Sen. Pres. Murray	Strengthens the Determination of Need (DON) process for outpatient capital projects and ambulatory surgery centers to help maintain standards of quality and ensure the efficient and equitable deployment. (Passed Senate and House; signed into law by governor, 8/10/08)
MS HB 629	Would repeal CON for all hospitals except specialty hospitals. (Filed 1/07; did not pass committee)
MS SB 2355	Would create a moratorium for "specialized programs" defined as soinal institutes, infant and child development programs and any other specialty hospital defined by the state. (Filed 1/07; did not pass committee)
NE L 765 Sen. Schimek	Relates to certificates of need; provides that no person shall establish, relocate or increase long-term care beds or rehabilitation beds, convert residential care beds to long-term care beds or change a domiciliary facility to convert domiciliary beds to long-term care beds. without having first applied for and received the necessary certificate of need. (Filed 01/09/2008; Passed Legislature 04/11/2008; signed into law by governor* 04/11/2008)*
NH SCR 6 Sen. Kenney	Non-binding resolution, urges the federal government to allow certain nursing homes to use a number of beds for respite care. (Filed 01/02/2008; passed Senate, passed House 05/14/2008; finally adopted* 05/14/2008*)
NC H 1685	Amends the certificate of need requirements to allow for an expedited review process for an adult care home or a nursing home to relocate within the same county. (Passed Senate and House; signed into law by governor, as Session Law 2007-473, 8/29/2007)
RI SB 3130 Sen. Alves	Creates a special legislative commission to study the issue of certificate of need including, but not limited to the requirements, fiscal impact, limitations, regulations, and specific conditions of approval for proposals. (HB 8154 filed 04/09/2008; adopted by House as Resolution 2008-155 on 04/09/2008). (SB 3130 filed 06/18/2008; passed House and Senate 07/08/2008; became law without governor's signature as Resolution 2008-379, 07/08/2008)
TN HB 3838 Rep. M. Turner	Permits relocation of licensed nursing home beds if the original facility has a certain annual occupancy rate, the relocation is in the facility's service area, the facility is part of a continuing care retirement community that offers long term care, the facility is licensed for a certain number of beds and an application is approved by the Health Services Development Agency. (Filed 01/30/2008; Passed House and Senate 06/03/2008; signed into law by governor* as Chapter 1089 on 06/10/2008)*
TN HB 3901 Rep. Coleman	Relates to the licensure and replacement of nursing homes and nursing home beds; provides with regard to a certificate of need to replace a nursing home that has ceased operations, the original facility is not required to maintain its license after the certificate of need has been approved for the replacement facility. (Filed 01/31/2008; Passed House and Senate 04/30/2008; signed into law by governor* as Chapter 844 on 05/07/2008)*
TN S 828 Sen. Cooper	Provides that public intermediate care facilities for the mentally retarded (ICF-MR) non facility beds established pursuant to certain federal litigation settlements are exempt from all requirements and processes for the application and granting of certificates of need. (Filed 01/31/2008; Passed House and Senate 04/30/2008; signed into law by governor* as* Chapter No. 307 on 05/31/2007)
UT HB 366 Rep. Newbold	Amends the facility licensing chapter and the medical assistance chapters of the Health Code; removes the authority of a Medicaid certified nursing care facility to increase its Medicaid certified bed capacity without Department of Health oversight; eliminates bed banking by such facilities for the purpose of Medicaid reimbursement; requires the Department of Health to adjust the Medicaid reimbursement methodology for such facilities. (Filed 01/31/2008; Passed House and Senate 03/18/2008; signed into law by governor* as Chapter 347, 04/02/2008)*
VT H 380 Rep. Donahue	Amends hospital reporting and licensing requirements; provide hospitals with greater flexibility in how community needs assessments are conducted; eliminates mandatory biannual revisions to the health resource allocation plan; requires the public oversight commission to make recommendations regarding revisions to the health resource allocation plan; amends the certificate of need laws; provides for the regulation of mobile health screening facilities; regulates public reporting requirements. (Filed 2/23/2007; Passed House and Senate; signed into law by governor* as Chapter 27 on 05/16/2007)*
VT HB 777	Relates to the rules and procedures regarding the competitive application process for certificates of need; relates to issuance, denial, and revocation of certificates of need; relates to the authority of the Commissioner regarding certificates of need; provides administrative sanctions for any person who offers or develops any new health care project without first obtaining a certificate of need. (Filed 01/31/2008; Passed House and Senate 05/09/2008; signed into law by governor* as Chapter 139 on 05/09/2008)*
VA HB 398 Rep. Hamilton	Relates to relocation of nursing home beds; adds to the definition of project any relocation of nursing home beds from one existing facility to another existing facility owned or controlled by the same person not located at the same site, in any three year period. (Filed 01/09/2008; Passed House and Senate 03/26/2008; signed into law by governor* as Chapter 664, 04/18/2008)*
VA HB 502 Hamilton	Relates to certificate of public need and fostering competition; creates a preference for proposed services or facilities to be established in health planning regions in which a single health care provider system controls a specified percentage of the existing acute care beds and earns more than a specified amount in aggregate annual net patient revenues when determining whether a public need for a project has been demonstrated. (Filed 01/09/2008; Passed House and Senate 03/04/2008; signed into law by governor* as Chapter 292 on 03/24/2008)*
VA HB 819 Rep. Albo	Relates to public need for nursing facilities; allows nursing facilities in continuing care retirement communities to participate in the Medical Assistance Program; allows these facilities to be exempt from certificate of public need requirements as long as no resident receives federal or state public assistance funds during an open admissions period; relates discontinuation of open admissions. (Filed 01/09/2008; Passed House and Senate 04/23/2008; signed into law by governor* as Chapter 857 on 05/02/2008)*
VA HB 1498 Rep. Kilgore	Requires the Commissioner to issue a Request For Applications, and to accept applications for 120 new nursing home or nursing facility beds in Planning District 3; requires preference to an applicant that proposes to establish a new nursing facility located within three miles of the boundary of the county seat or within the county seat of the county adjacent to the city or county in which is sited any facility in Planning District 3. (Filed 01/17/2008; Passed House and Senate 04/02/2008; signed into law by governor* as Chapter 802 on 06/27/2008*)
WA H 2304	Provides for the issuance of a certificate of need for certain cardiac care services; provides that, to promote the stability of the state's cardiac care delivery system, the Department of Health shall adopt rules for criteria for issuance of a certificate of need for the performance of elective percutaneous coronary interventions at hospitals that do not otherwise provide on-site cardiac surgery; provides the a related review shall include access to care, patient safety, costs and quality outcomes. (Signed into law by governor* as Chapter 2007-440, 5/11/2007)*

2005-06 Examples of CON State Legislation

State/Bill/Web link/Sponsor yellow background=enacted	Descriptions of Bills/Excerpts of bill text
AK HB 287 Rep. Lynn	An act amending the certificate of need requirements to apply only to health care facilities and nursing homes located in borough with a population of not more than 25,000, in the unorganized borough, or in a community with a critical access hospital. (Filed 4/27/05; did not pass by end of regular session, 2006)
CA* SB 666 Sen. Aanestad	An act to amend Section 1250 of the Health and Safety Code, relating to health facilities. (Filed 2/22/05; passed House 66y-4n, 9/8/05; passed Senate 44y-1n, 9/8/05; signed into law by Governor* as Chapter 443, 9/30/05)*
CT HB 5242 Rep. Dillon	An examination of the State's current and future hospital bed capacity and hospital-based graduate medical education. (Filed 2/16/06; did not pass by end of regular session, 2006)
CT HB 5468 Public Hlth. Comm.	To increase the certificate of need threshold for all capital expenditures, including major medical equipment, to three million dollars. (Filed 2/22/06; passed House 142y-0n 4/11/2006; passed Senate 35y-0n 4/21/06; signed into law by Governor* 5/8/06)*
CT HB 5719 Public Hlth. Comm.	To make the certificate of need process for new or expanded emergency medical services clearer and more consistent. (Filed 3/3/06; did not pass by end of regular session, 2006)
CT SB 309 Public Hlth. Comm.	To allow certified or licensed emergency medical service providers to add one emergency vehicle to their service every three years without undergoing a needs assessment by the Office of Emergency Medical Services, to clarify the Commissioner of Public Health's responsibilities with respect to establishing methods for setting emergency service rates for certified ambulance services and to protect patients from the dangers of secondhand smoke while being transported to or from nonemergency medical services. (Filed 2/22/06; did not pass by end of regular session, 2006)
CT SB 386 Public Hlth. Comm.	To revise statutes pertaining to the Office of Health Care Access. (Filed 2/23/06; passed Senate 33y-0n 4/20/06; passed House 146y-0n 4/28/06; signed into law by Governor* 5/19/06)*
CT SB 621 Public Hlth. Comm.	To require the Department of Health to establish a standard set of exemptions for single specialty outpatient surgical facilities from licensure and certificate of need requirements. (Filed 3/8/06; did not bass by end of regular session, 2006)
FL HB 1565 Rep. Needelman	Would require county commissioners board to issue certificate of public convenience & necessity to any municipality that applies for such certificate to provide advanced life support transport or nontransport emergency medical services within its geographic limits or outside its geographic limits by mutual agreement with governing body of jurisdiction served, etc. (Filed 3/8/05; died in committee 5/6/05)
FL HB 1829	For Holmes County Hospital Corporation, amends special act and revises provisions regarding corporation's issuance of bonds to construct and erect new hospital facility in Holmes County; repeals various provisions of said special act. (Passed House and Senate; signed into law by governor* as Chapter No. 2005-352, 6/13/06) \|*
FL HB 7051 Rep. Gibson	Extends moratorium on certificates of need for additional community nursing home beds until July 1, 2011; specifies nonapplication of moratorium for addition of nursing home beds in certain specified facilities; provides for repeal upon expiration of moratorium; exempts nursing home that is created by combining certain licensed beds from requirements for obtaining certificate of need from AHCA, etc. (Filed 2/22/06; passed House 120y-0n 4/19/06; passed Senate 34y-0n 4/20/06; signed into law by Governor* 6/9/2006 )*
FL HB 7141 Rep. Garcia	Requires healthcare providers to display licenses; exempts nursing home created by combining certain licensed beds from requirements for obtaining certificate of need from AHCA; establishes trauma center startup grant program, etc. (Filed 3/17/2006; passed House 114y-0n, 4/28/06; passed Senate 40y-0n, 5/4/06; signed into law by Governor* 6/12/06)*
FL SB 1516 Sen. Wilson	Would create intergenerational respite care assisted living facility pilot program; provides duties of AHCA re program; provides requirements & standards for program; provides for rules; requires report to Legislature. (Filed 2/15/05; did not pass by end of regular session, 2006)
FL SB 2158 Sen.	Would amend provision re health-care-related projects subject to review for certificate of need; exempts class II specialty hospitals specializing in delivery of health services to pediatric patients from requirement to obtain certificate of need from AHCA; provides criteria for such exemption. (Filed 2/16/06; died in committee 3/22/06; did not pass by end of regular session)
GA HB 390 Rep. Scott	State Commission on the Efficacy of the Certificate of Need Program. (Filed 2/9/05; passed House 151y-0n 3/3/05; passed Senate 42y-0n, 3/22/05; signed into law by Governor 4/7/05) ALSO: See GA Final CON Report 12/06
GA SB 242 Sen. Hudgens	Relates to the certificate of need program, so as to provide for an exemption from the certificate of need requirements for the voluntarily relocation of a health care facility under certain conditions; to provide for an exemption from the certificate of need requirements for the relocation, repair, or replacement of a health care facility that is damaged, destroyed, or rendered inoperable under certain conditions; to provide for related matters; to provide for an effective date; to repeal conflicting laws; and for other purposes. (Filed 2/23/05; did not pass by end of regular session, 2005)
HI HB 137 Rep. Evans	Exempts all long-term care facilities at all levels of care from the certificate of need process under the state health planning and development agency. (Filed 1/20/2005; carried over to 2006 session 12/2/05)
IL SB 569 Sen. Garrett	Amends the Illinois Health Facilities Planning Act. Provides that "capital expenditure minimum" means $10,000,000 (now, 6,000,000) and "non-clinical service area" includes research facilities, auditoriums, and medical office buildings. Provides that permits are not required for the establishment of swing-beds authorized under Title XVIII of the federal Social Security Act, or for the modification of a hospital's bed capacity. Provides that the Illinois Health Facilities Planning Act is repealed on July 1, 2011 (now July 1, 2006). Effective immediately. (Filed 2/17/05; passed Senate 56y-0n 4/14/05; did not pass by end of regular session, 2005)
IL SB 2436 Sen. Crotty	Amends the Illinois Health Facilities Planning Act. Requires inventories of certain skilled or intermediate care facilities to be conducted annually by July 1, to list services provided, and to differentiate between active and inactive beds. Effective immediately. (Filed 1/18/06; passed Senate 57y-0n 3/2/06; passed House 105y-4n 5/4/06; signed into law by Governor* 6/30/06)*
IN SB 161 Sen. Miller	Moratorium on comprehensive care beds. Imposes a moratorium on the construction or addition of comprehensive care beds through June 30, 2007, with certain exceptions. (Filed 1/9/06; passed Senate 45y-2n 1/26/06; passed House 88y-0n 3/1/06; signed into law by Governor* 3/20/06)*
IA HSB 614 SSB 3072 Chair Upmeyer	An Act relating to placing nursing facility beds in reserve. (Filed 1/31/06; did not pass by end of regular session, 2006)
KS HB 2799	Concerns adult care homes, relating to home plus beds. (Filed 2/1/06; did not pass by end of regular session, 2006)
KS HR 6036	Would Memorialize the Congress of the United States regarding the benefits of specialty hospitals. (Filed and sent to committee, 4/29/06; did not pass by end of session, 6/06)
KS S.R. 1856, SR 1862	Memorializes the U.S. Congress to continue the current federal moratorium on specialty hospitals. (Filed 4/1/06; SR 1862 passed Senate* 4/30/06) \|*
KY SB 61 Sen. Kelly	To replace the Office of Certificate of Need with the Office of Health Policy for Health and Family Services. (Filed 1/6/06; passed Senate 92y-3n, 3/24/06; passed House 4/11/06; signed into law by Governor* in Acts Chapter 181, 4/18/06 )*
LA HB 1337 Rep. Thompson	To provide for the certificate of rural necessity program. (Filed 4/18/06; did not pass by end of regular session, 2006)
LA SB 311 Sen. Hines	Provides for the needs assessment review for the approval of federally qualified healthcare centers. (Filed 3/17/06; did not pass by end of regular session, 2006)
LA SB 754 Sen. Cravins	Related to adult day healthcare providers and to provide for related matters. (Filed 6/1/06; passed House 90y-0n, 6/16/06; passed Senate 32y-0n, 6/16/06; signed into law by Governor* as Act 637, 6/23/06)*

ME HB 1254 LD 1814 Rep. Miller	Proposes to amend the certificate of need law to improve review procedures in the certificate of need program within the Department of Health and Human Services. (Filed 12/28/2005; died in committee 4/26/06)
ME HB 1315 LD 1875 Rep. Millett	Provides improved services to persons in rehabilitation programs; Directs the Department of Health and Human Services, Office of Substance Abuse to evaluate need when issuing licenses, etc. (Filed 1/3/06; passed House 3/23/06; passed Senate 3/27/06; signed into law by Governor* 3/30/06)*
ME SB 225 LD 688 Sen. Dow	An act to ensure access to swing beds in hospital (Filed 2/10/05; died in committee 5/23/05)
ME SB 490 LD 1401 Sen. Brennan	To further coordinate the laws regarding certificate of need, the state health plan and the Capital Investment Fund. (Filed 3/22/05; passed House 6/8/05; passed Senate 6/8/05; signed into law by Governor* 6/10/05)*
ME SB 701/LR 2677 LD 1784 Sen. Rosen	Requires the Department of Health and Human Services to allow construction contingency budgeting for capital projects that is consistent with industry standards in a certificate of need application. (Filed 12/30/05; passed House 4/10/06; passed Senate 4/10/06; signed into law by Governor* 4/13/06)*
ME SB 852 LD 2110 Comm. of HHS	Repeals the Hospital Cooperation Act of 1992; Enacts the Hospital and Health Care Provider Cooperation Act. (Filed 4/13/06; passed House5/23/06; passed Senate5/23/06; signed into law by Governor* 5/30/06)*
MD HB 1015/SB 832 Rep. Pendergrass	Altering the level of capital expenditures made by or on behalf of a hospital or a health care facility other than a hospital that requires a certificate of need, etc. (Filed 2/9/06; passed House 4/1/06; passed Senate 4/1/06; Governor vetoed* 5/26/06)*
MD HB 1105 Rep. Morhaim	Requiring the Maryland Health Care Commission to adopt rules and regulations for certification of need that provide consideration for hospital projects that incorporate the requirements for a high performance building; and requiring the Health Services Cost Review Commission, in the determination of reasonable rates for each facility, to take into account the costs of hospital projects that incorporate the requirements for a high performance building. (Filed 2/9/06; passed House 3/17/06; did not pass by end of regular session, 2006)
MD HB 1420/SB 529 Rep. Smigiel	Repealing a specified requirement for a specified State health plan relating to the certificate of need program, etc. (Filed 2/10/06; did not pass by end of regular session, 2006)
MA S 1293 Sen. Moore	Determination of need for hospital beds. (Filed 1/26/05; did not pass by end of regular session, 2005)
MA S. 1299	Would study the delivery of specialty hospitals. (Filed 1/5/05; did not pass by end of regular session, 3/20/06)
MA S 2141 Public Hlth Comm.	Amends law regulating need for hospital beds. (Filed 6/30/05; did not pass by end of regular session, 2006)
MA HD 4853 Rep. Koutoujian	The Department of Public Health be required to hold public hearings before the removal of publicly-funded beds under the jurisdiction of the Commonwealth. (Filed 12/19/05; did not pass by end of regular session, 2006)
MN HF 1380/ SF 1297 Solberg	Human services; extends deadline for a nursing facility moratorium exception project in Aitkin County. (Filed 2/28/05; did not pass by end of regular session, 2005)
MN HF 1422 Rep. Bradley	To modifying license fees, state-operated services, nursing facility reimbursement, children and families programs, and other provisions; providing positive abortion alternatives; and appropriating money. (Filed 2/28/05; did not pass by end of regular session, 2005)
MN HF 1862 Rep. Abeler	Creates evidence-based practice standards, achieves cost-containment measures, allows discounted payments, modifies other health insurance provisions and appropriates money. (Filed 3/16/05; did not pass by end of regular session, 2006)
MN HF 3933 Rep. Westrom	Hospital construction and modification moratorium and public interest review requirements for hospitals eliminated. (Filed 3/27/06; did not pass by end of regular session, 2006)
MN SF 2232/ HF 2360 Sen. Belanger	Nursing home bed moratorium exception project deadline extension. (Filed 4/18/06; did not pass by end of regular session, 2006)
MN SF 2576/ HF 3049 Sen. Sparks	Ambulance purchase and lease regulations; hospital construction proposals; alternative approval process, etc. (Filed 5/26/06; passed House 5/20/06; passed Senate 5/20/06; signed into law by Governor* 5/26/06)*
MS HB 082/HB 083 Rep. Woods	Removes all except specialty hospitals from application of certificate of need law; Authorizes construction of new acute care hospital. (Filed 1/3/06; died in committee 1/31/06)
MS HB 296 Rep. Flaggs	Certificate of need; authorizes nursing home for disabled adults. (Filed 1/5/06; died in committee 1/31/06)
MS HB 452 Rep. Fillingane	Nursing homes may add up to 60 new beds if have 95% occupancy rate. (Filed 1/6/06; died in committee 1/31/06)
MS HB 457 Rep. Fillingane	Repeal sections 41-7-171 through 41-7-209 from Mississippi Code of 1972, which are the Mississippi Health Care Certificate of Need Law of 1979 etc. (Filed 1/6/06; died in committee 1/31/06)
MS HB 389 Rep. Holland	To amend sections 41-7-173 and 31-7-191 from Mississippi Code of 1972 regarding hospices requiring a health care certificate of need by the State Department of Health. (Filed 1/10/06; died in committee 1/31/06)
MS HB 599 Rep. Holland	To require the Division of Medicaid to allow certain faith-based assisted living facilities to participate in the Medicaid Assisted Living Waiver Program and related purposes. (Filed 1/10/06; died in committee 2/28/06)
MS HB 600 Rep. Robinson	Amends section 41-7-191 of Mississippi Code of 1972 to issue a certificate of need for the addition of hospital beds. (Filed 1/10/06; died in committee 1/31/06)
MS HB 601 Rep. Martinson	Amends section 41-7-191 of Mississippi Code of 1972 to authorize a health care certificate of need for ICF-MR beds in community living programs for developmentally disabled adults. (Filed 1/10/06; died in committee 1/31/06)
MS HB 1095 Rep. Young	For the State Department of Health to provide a health care certificate of need for Psychiatric Residential Treatment Facility beds to be transferred; etc. (Filed 1/16/06; died in committee 1/31/06)
MS HB 1221 Rep. Compretta	Relates to moving nursing home beds from one facility to another; etc. (Filed 1/16/06; passed House 3/22/06; passed Senate 3/22/06; signed into law by Governor* 3/29/06)*
MS HB 1231/HB 1232/HB 1234 Rep. Flaggs	Relates to an ambulatory surgical facility; certain offices of private physicians shall require certificates of need; Revises the list of activities that require certificates of need. (Filed 1/16/06: died in committee 1/31/06)
MS HB 1283 Rep. Baker	Specifies requirements for issuance of CON for relocation of a health care facility. (Filed 1/16/06; died in committee 1/31/06)
MS SB 2011/SB 2018 Sen. Thomas	Certificate of Need Program for ICF/MR beds in a community living program for developmentally disabled adults; Nursing facility beds at "Green House Model" campus located in Yazoo city. (Filed 1/4/06; died in committee 1/31/06)
MS SB 2453 Sen. Nunnelee	Certificate of Need Program for community living program for developmentally disabled adults in Madison County. (Filed 1/10/06; died in committee 1/31/06)
MS SB 2482 Sen. Thomas	Clarifies Certificate of Need Program for the relocation of a health care facility. (Filed 1/12/06; died in committee 1/31/06)
MS SB 2522 Sen. Jackson	Creates an establishment for the Home Health Agency in Kemper County. (Filed 1/12/06; died in committee 1/31/06)
MS SB 2593 Sen. Burton	Relates to certificates of need that will transfer ICF/MR and child psychiatric beds from one facility to another. (Filed 1/13/06; died in committee 1/31/06)
MS SB 2645 Sen. Brown	Medicaid reimbursement for nursing facility beds under Certificate of Need Programs in Columbus. (Filed 1/13/06; died in committee 1/31/06)
MS SB 2650 Sen. Lee	Relates to psychiatric treatment facility beds in Simpson County. (Filed 1/16/06; died in committee 1/31/06)
MS SB 2661 Sen. Burton	Clarifies definition of ambulatory surgical facilities under Certificate of Need Program. (Filed 1/16/06; died in committee 1/31/06)
MS SB 2675 Sen. Nunnelee	Revises definition of ambulatory surgical facilities and licensure under Certificate of Need Program. (Filed 1/16/06; died in committee 1/31/06)
MS SB 2731 Sen. Nunnelee	Relates to health care facility activities under Certificate of Need Program. (Filed 1/16/06; died in committee 1/31/06)
MS SB 2750 Sen. Dawkins	Would impose a certificate of need moratorium on specialized programs offered by hospitals. (Filed 1/16/06; died in committee 1/31/06)
MS SB 2844 Sen. Horhn	Would authorize a certificate of need program for a nursing facility in any undeserved minority zip code area in the state. (Filed 1/16/06; died in committee 1/31/06)
MS SB 2850 Sen. Kirby	Would move nursing home beds from one facility to another and to construct another facility. (Filed 1/16/06; died in committee 1/31/06)
MS SB 2959 Sen. Lee	Would transfer certificates of need from Hancock to Stone and other counties. (Filed 1/16/06; died in committee 1/31/06)
MO HB 1537 Rep. Shaaf	Refers to 'long-term care facilities' for the purpose of the Certificate of Need Program and limits application of certificate of need requirements to long-term care facilities. (Filed 1/25/06; did not pass by end of regular session, 2006)
NJ AB 1469 Assm. O'Toole	Requires certain background checks for assisted living administrators and applicants for certificate of need. (Filed 1/10/06; Referred to committee 2/2/06)
NJ AB 2691 Assm. Stanley	Prohibits granting certificates of need for hospital closures in service areas with high incidence of morbidity unless DHSS has plan to manage public health emergency. (Filed 2/23/06; Referred to committee 2/27/06)
NJ ACR 120/SCR 53 Asmb. Van Drew	Urges DHSS to allocate 25% of new slots that are available in FY 2006 under Enhanced Community Options waiver to assisted living program providers. (Filed 1/17/06; Referred to committee 2/26/06)
NY AB 3263 Rep. Gottfried	To amend the public health law, in relation to nursing home staffing levels. (Filed 2/1/06; Referred to committee 2/1/06)
NY AB 3266 Rep. Gottfried	To amend the public health law, in relation to a nurse staffing centers; Additional powers and duties for the Commissioner of Health; Authorizes such commissioner to establish an advisory committee to advise in related issues; etc. (Filed 2/1/06; Referred to committee 2/1/06)
NY AB 3928 Rep. Brennan	An act to amend the mental hygiene law, in relation to establishing minimum staffing ratios in facilities operated under the jurisdiction of the office of mental health. (Filed 2/7/06; Referred to committee 2/7/06)
NY AB 5346 Rep. Gottfried	An act to amend the public health law, in relation to hospital establishment. (Filed 2/18/06; Referred to committee 2/18/06)
NY AB 11920/ S 7494 Rep. Gottfried	Relates to the limitation on the number of continuing care retirement community beds in the state. (Filed 6/16/06; passed House 6/23/06; passed Senate 6/23/06)
NY SB 3943 Sen. Oppenheimer	Requires health commissioner to make certain findings concerning access to health care services as a prerequisite to approving applications for establishment, incorporation or construction of certain health care facilities. (Filed 4/5/05; Referred to committee 4/4/05)
NY SB 4572 Comm. for Public Hlth.	Establishes minimum staffing levels of types of various personnel in nursing homes throughout any particular day; creates the advisory council on nursing home staffing to make recommendations to the governor, legislature and commissioner of health on nursing home staffing; requires public disclosure by each nursing home of its staffing levels and reporting thereof to the department of health. (Filed 4/15/05; Referred to committee 4/15/05)
NY SB 5718/AB 8877	Relates to increasing availability of services in certain assisted living programs. (Filed 6/15/05; passed Assembly 6/23/05; passed Senate 6/23/05; signed into law by Governor* Chapter 593, 8/23/05 )*
NY	The Commission on Health Care Facilities in the 21st Century report proposes major adjustments in existing facilities including closings and downsizing. A Prescription for New York City’s Health Care Crisis: Recommendations of the New York City Council Hospital Closing Task Force. (Report issued 11/06)
NC HB 905 Rep. Culpepper	To amend the Certificate of Need Laws. (Filed 3/24/05; referred to committee 4/6/05)
NC HB 1060 Rep. Wright	To change the definition of "Critical Access Hospital" to conform to federal law. (Filed 3/30/05; passed House 4/13/05; passed Senate 8/23/05; signed into law by Governor* 9/02/05)*
NC HB 2375 Rep. Nye	To appropriate funds to the Department of Health and Human Services, Division of facility services, to enhance fair and consistent application of the certificate of need law and health planning process. (Filed 5/22/06; Referred to committee 5/23/06)
NC SB 740 Sen. Rand	To amend the Certificate of Need Laws. (Filed 3/21/05; passed House 7/13/05; passed Senate 8/16/05; signed into law by Governor* 8/26/05)*
NC SB 1161/HB 1112 Sen. Apocada	Requires the Department of Health and Human Services to develop a central registry of available beds in mental health facilities to assist in the placement of individuals involuntarily committed to the facilities. (Filed 3/23/05; did not pass by end of regular session, 2006)
PA HB 2443 Rep. Killian	Relates to health care; delegating responsibilities to the State Health Coordinating Council, etc., providing certificates of need for health care providers and prescribing penalties, etc. (Filed 2/8/06; Referred to committee 6/13/06)
PA SB 1253 Sen. Greenleaf	Exempts continuing care retirement communities from the medical assistance bed approval process and allowing nursing facilities operated by continuing care retirement communities to obtain medical assistance certified beds under limited terms and conditions. (Filed 6/22/06; Referred to committee 6/22/06)
RI HB 5868 Rep. Landroche	Relating to Businesses and Professions, Board of Medical Licensure and Discipline, and self-referral. (Filed 3/1/05; Did not pass by end of regular session, 2005)
RI HB 5870 Rep. Lewiss	Relates to health and safety and the licensing of health care facilities. (Filed 3/1/05; Did not pass by end of regular session, 2005)
RI HB 5915 Rep. Savage	Relates to determination of need for new health care equipment and new institutional health care institutions. (Filed 3/1/05; Did not pass by end of regular session, 2005)
RI HB 7622 Rep. Long	Relates to determination of need for new health care equipment and new institutional health care institutions. (Filed 2/16/06; Did not pass by end of regular session, 2006)
RI HB 8055 Rep. Long	Determination of Need for New Health Care Equipment and New Institutional Health Services (Filed 5/2/06; passed House6/22/06; passed Senate 6/23/06); signed into law by Governor, 7/5/06)
RI HB 8246 Rep. Slater	Amends the definitions section, review and approval section, procedures for review section, and application fees section in the "Determination of Need for New Health Care Equipment and New Institutional Health Services" (Filed 6/15/06; Did not pass by end of regular session, 2006)
RI SB 426 Sen. Gibbs	To analyze applications for certificate of need. (Filed 2/10/05; Did not pass by end of regular session, 2005)
RI SB 784 Sen. Roberts	Amends sections in the Determination of Need for New Health Care Equipment and New Institutional Health Services. (Filed 2/17/05; Did not pass by end of regular session, 2005)
RI SB 798 Sen. Badeau	Relates to self-referral by medical practitioners; remove the capital cost test for application/installation or radiologic equipment. (Filed 2/17/05; Did not pass by end of regular session, 2005)
RI SB 2741 Sen. Roberts	To reduce the size and make-up of the health services council. (Filed 2/14/06; passed House 6/23/06; passed Senate 6/22/06; signed into law by Governor* 7/5/06)*
SC HB 3601/SB 582 Rep. Pitts	Relates to the State Health Planning Committee including the development and contents of the state health plan for use in the Administration of the Certificate of Need Program, so as to require the state health plan to include a provision that the Department of Health and Environmental Control shall approve a certificate of need application for open heart surgery if the applicant meets certain criteria. (Filed 2/22/05; Referred to committee 2/22/05)
SC SB 1054 Sen. Peeler	Relates to the State Health Planning Committee including the development and contents of the state health plan for use in the approval of certificates of need, including a certificate of need for methadone treatment facilities; provides that a certificate of need is required for the acquisition of certain medical equipment. (Filed 1/18/06; Referred to committee 1/18/06)
SC SB 1260 Sen. Hutto	Relates to certificate of need requirements for home health agencies, so as to exempt from these requirements private duty home care agencies that participate in state-funded waiver programs, that continuously have provided these services since January 1, 2001, and that are accredited by the Joint Commission for the accreditation of health care organizations. (Filed 3/16/06; Referred to committee 3/16/06)
TN HB 228/SB 1751 Rep. Overbey	To increase state expenditures to the extent the replacement facility increases the nursing home bed pool, there could be an increase in the number of beds. Such an increase could result in an increase in expenditures exceeding $1,000,000 ($360,000 in state fund and $640,000 in federal funds). (Filed 2/1/05; passed House 94y-0n, 5/22/05; passed Senate 32y-0n, 5/4/05; signed into law by Governor* as Chapter 385, 5/23/05)*
TN HB 1088/SB 1007 Sen. Ford	Concerns hospitals and health care facilities; revises certificate of need requirements for relocation and partial replacement of nursing home beds and facilities. (Filed 2/4/05; passed House 93y-0n 5/27/05; passed Senate 30y-0n 5/19/05; signed into law by Governor* as Public Chapter 445, 6/24/05)*
TN HB 1112/SB 687 Rep. McMillan	Prohibits issuance of certificates of need for new nursing home beds between July 1, 2005 and June 30, 2007, except for certain Medicare skilled nursing facility beds. (Filed 2/4/05; passed House 97y-0n, 5/12/05; passed Senate 31y-on, 4/28/05; signed into law by Governor* as Chapter 237, 5/27/05)*
TN HB 1986/ SB 2113 Rep. Harmon	Exempts PACE program from certificate of need required to provide nursing home (Filed 2/17/05; Referred to committee 3/30/05)
TN HB 2010/SB 2103 Sen. Strader	Imposes a one-year moratorium on certificates of need for non-residential methadone treatment facilities. (Filed 2/17/05; Referred to committee 4/17/05)
TN HB 2211/SB 1551 Rep. Buck	Changes the maximum time allowed for reviewing agencies to report concerning a certificate of need application to the health services and development agency from 60 to 50 days. (Filed 2/3/05; Did not pass by end of regular session, 2005)
TN HB 3324/SB 3349 Rep. Finney	Clarifies that applications for a certificate of need shall be filed within five business days from the date of publication of the letter of intent. (Filed 2/16/06; Referred to committee 3/5/06)
TN SB 2958/HB 3026 Sen. Cooper	Increases the total number of beds in ICF/MR facilities that have been providing state-contracted services to persons with developmental disabilities for at least five years by 50 beds per year for the next four years after July 1, 2006. This change would result in a maximum of 868 beds by June 30, 2009. (Filed 2/15/06; passed House 98y-0n 5/11/06; passed Senate 32y-0n 4/20/06; signed into law by Governor as Chapter 761, 5/25/06)
VT HB 35 Rep. Obuchowski	Health; health care administration; health facilities; discontinuance of services; licensing of hospitals; open meetings; public records; certificate of need; hospital budgets. (Filed 1/13/05; Referred to committee 1/13/05)
VT HB 450 Rep. Hube	To reform Vermont's Certificate of Need Laws. (Filed 3/8/05; Referred to committee 3/8/05)
VT HB 567 Rep. Keenan	Relates to exemption from certificates of need and HMO requirements for PACE. (Filed 1/20/06; passed House 2/3/06; passed Senate 2/3/06; signed into law by Governor* 2/15/06*
VA HB 267 Rep. Cole	Authorizes the submission of an application for an increase in nursing home beds, either on-site or through relocation within the same city or county, for a facility that was licensed for less than 40 beds under certain specific conditions. (Filed 1/4/06; passed House 98y-1n, 2/14/06; passed Senate 40y-0n, 3/7/06; signed into law by Governor* as Chapter 816, 4/6/06)*
VA HB 381 Rep. Suit	The bill authorizes the facility to request an amendment to its previous certificate of public need to admit persons, other than residents of the cooperative units, to its nursing home facility beds. The facility must be: (i) operated by an association described in § 55-458; (ii) created in connection with a real estate cooperative; and (iii) providing its residents a level of nursing services consistent with the definition of continuing care in Chapter 49 (§ 38.2-4900 et seq.) of Title 38.2. (Filed 1/6/06; passed House 94y-0n, 1/24/06; passed Senate 40y-0n; 3/6/06; signed into law by Governor* as Chapter 776, 4/6/06)*
VA HB 1139 Rep. Cline	Requires the Board of Health to develop staffing regulations specific to entities that are concurrently licensed as a hospice and an assisted living facility that would not require the presence on each shift of a registered nurse for any concurrently licensed facility that has no more than four beds and operates within an integrated healthcare system. (Filed 1/11/06; Died in committee 1/24/06)
VA HB 2243 Rep. O'Bannon	Revises the designation of the parties to the case if an informal fact-finding conference is determined to be necessary by the Department of Health or is requested by a person seeking good cause standing. In such cases, the designation of the parties to the case will include the relevant health planning agency. (Filed 1/11/05; passed House 96y-0n, 2/7/05; passed Senate 40y-0n 2/22/05; signed into law by Governor* as Chapter 404, 3/21/05)*
VA HB 2316 Rep. Griffith	Certificate of Public Need; relocation of certain nursing home beds under limited circumstances. (Filed 1/11/05; passed House 79y-17n, 1/26/05; passed Senate 38y-1n, 2/21/05; signed into law by Governor* as Chapter 99, 3/24/05)*
VA HB 2639 Rep. Hurt	Requires the Commissioner of Health to reissue a Request for Applications for 60 new nursing home or nursing facility beds in Planning District 12 when the scheduled construction date has passed, the company issued a certificate pursuant to a 1997 Request for Applications has not begun construction, and the certificate has expired. (Filed 1/12/05; passed House 97y-0n, 2/1/05; passed Senate 40y-0n, 2/14/05; signed into law by Governor* as Chapter 838, 3/26/05)*
VA HB 2826/ SB 1237 Rep. Orrock	Authorizes DMHMRSAS to license providers of services under the Medicaid Brain Injury Waiver and providers of residential services for persons with brain injury. The bill requires the State Board of Mental Health, Mental Retardation and Substance Abuse Services to promulgate necessary regulations within 280 days of enactment. (Filed 1/19/05; passed House 94y-2n, 2/8/05; passed Senate 40y-0n, 2/22/05; signed into law by Governor* as Chapter 725, 3/25/05)*
VA SB 426 Sen. Lambert III	Defines "reduced rate," for the purpose of the Commissioner's conditions on approval of a certificate of need. (Filed 1/11/06; Died in committee 1/19/06)
VA SB 839 Sen. Cuccinelli	Requires the regulation of abortion clinics as a category of outpatient surgical hospital and sets forth the requirements for the licensure of abortion clinics in a new article. Abortion clinics will not be required to comply with certificate of public need requirements or health care data reporting. The provision becomes effective on January 1, 2006. (Filed 1/3/05; Referred to committee 2/3/05)
WA HB 1688 Rep.	Creating a task force to review the certificate of need program and the health care facilities bonding program. (Filed 2/2/05; passed House 71y-25n, 3/14/05; passed Senate 34y-11n, 4/7/05; signed into law by Governor* as Chapter 283, 5/4/05)*
WA SB 5178	Establishes a moratorium on licensing physician owned specialty hospitals, from Jan 1, 2005 to July 1, 2006. (Filed 1/17/05; passed Senate and House; signed into law by governor* as Chapter 39, 4/13/06) \|*
WA SB 6278	Relates to licensing specialty hospitals. (Filed 1/10/06; favorable report 2/1/06; did not pass by end of session 3/06)
WV HB 4682 Rep. Amores	Establishing standards for and guidance to the West Virginia Health Care Authority in amending and modifying certificate of need standards. (Filed 2/21/06; Referred to committee 2/21/06)
WV SB 569 Sen. Caruth	Exempting ventilator beds from certificate of need requirement. (Filed 2/15/06; Referred to committee 2/15/06)
WV SB 745 Sen. Bowman	Authorizing certain nursing homes to obtain certificates of need for additional beds. (Filed 2/20/06; Referred to committee 2/20/06)
WV SB 773 Sen. Kessler	Establishes certificate of need standards. (Filed 2/22/06; passed House 3/10/06; passed Senate 3/1/06; signed into law by Governor* as Chapter 101, 3/23/06)*
WY SB 57	Provides for a study of medical specialtyspecialtyspecialty centers and new general hospitals by the Wyoming health care commission. Provides a temporary moratorium on licensing of new hospitals or medical specialty centers, requires a report by November 2006; provides an appropriation (Filed 1/24/06; passed Senate and House; signed into law by governor* as Chapter 112, 3/24/06)*

Additional Professional Reports and Opinions:

State Legislation Relating to Transparency and Disclosure of Health and Hospital Charges - NCSL report, updated 2009.
Medical/Surgical Bed Occupancy Rate Targets - AHPA Newsletter, 2007 (page 7)
Certificate of Need Programs - A consumer guide & Overview by Community Catalyst & FUSA, 2009.
DaimlerChrysler Corporation. Certificate of Need: Endorsement by DaimlerChrysler Corporation, February 2002:
Illinois: Hospital Approval Laws Criticized by U.S. Antitrust Agencies - SHN, 9/15/08.
"Certificate of Need: Protecting the Public Interest" Slides by Thomas Piper, Director MO CON Program. 8/06.
Ambulatory Surgery Center Payment Information Now Available - report by CMS, 11/06.
Hospital Inpatient Payment Information Now Available - report by CMS, 8/06.
Massachusetts Special Commission on Ambulatory Surgical Centers & Medical Diagnostic Services - legislative report, 6/30/07.

Authors: 2007-09 edition research and updates by Richard Cauchi, Health Program Director, Denver, Colorado
Additional research and writing contributed by Karmen Hanson (2006-07) and Andrew Thangasamy (2008) and Ariel Victoroff (2006). Earlier material and editions by Elana Mintz (2000), Andrew McKinley (2004)

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