N.C. Speaker of the House Thom Tillis called for the review in August, hoping to reduce the legal battles surrounding CON requests in the state. Under the current regulations, nearly all healthcare facilities — from hospitals to physician offices — planning to expand, replace facilities or buy large equipment must receive approval from the state’s Department of Health and Human Services. The requests are often opposed by competing providers, creating a potentially lengthy approval process for new facilities.
In September, the state denied a CON application from Cone Health, which sought to build a new ambulatory surgery center at its MedCenter High Point (N.C.) facility. The project faced objections by a number of competitors, and the state rejected the application on the grounds that new surgery services were not necessary in the community.
Even when CON requests are initially approved by the state, objections from competitors can draw out the process. Wake Forest Baptist Medical Center, based in Winston-Salem, N.C., continues to wait for a decision from the N.C. Division of Health Service Regulation on whether the hospital’s proposed $38.7 million ASC can proceed. State regulators approved a CON for the proposed 72,300-square-foot surgery center in June 2010. The project was then appealed by Novant Health, forcing the matter to the N.C. Division of Health Service Regulation.
According to the report, healthcare providers could save thousands if the process were reformed. Healthcare facilities currently spend thousands to file and defend their applications, a significant burden for smaller providers such as ambulatory surgery centers and physician practices.
Bart Walker, a healthcare attorney in Charlotte for McGuireWoods, told the Journal that elimination of the CON process would be surprising in North Carolina. Instead, legislators may opt to restrict appeals, allow alternate-dispute resolution or streamline the process in other ways. He says currently, the CON process acts as a barrier to new providers, creating a three- to seven-year wait to build new facilities.
Legislation on the CON process is not expected until 2013.
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