The states with no certificate-of-need laws 

Sixteen states have no certificate-of-need laws, according to a report from HealthCare Appraisers, a consulting firm. 

Certificate-of-need laws, which govern where healthcare providers can build facilities, have been a hurdle many ASCs have had to clear for years. In October, South Carolina became the latest state to remove the requirement when Gov. Henry McMaster signed a bill repealing the state's certificate-of-need law.

"I think certificate-of-need laws reduce the positive impact ASCs could have on the healthcare system," Michael Chwalek, senior financial analyst at Ambulatory Surgical Centers of America, told Becker's. "They restrict the number of ASCs through rationing and creating a significant barrier to entry. The time and legal and consulting fees required to gain certificate-of-need approval significantly increase the risk of starting a center."

Here are the states with no certificate-of-need laws:

  1. Arizona
  2. California
  3. Colorado 
  4. Idaho
  5. Kansas
  6. Minnesota
  7. New Hampshire
  8. New Mexico
  9. North Dakota
  10. Pennsylvania
  11. South Carolina
  12. South Dakota
  13. Texas
  14. Utah
  15. Wisconsin
  16. Wyoming

Here are the states with certificate-of-need laws that do not apply to ASCs:

  1. Arkansas
  2. Florida
  3. Indiana
  4. Louisiana
  5. Missouri
  6. Montana 
  7. Nebraska 
  8. Ohio
  9. Oklahoma
  10. Oregon

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