Connecticut has enacted a sweeping overhaul of its certificate-of-need program, shifting regulatory authority from the Office of Health Strategy to a new three-member CON Panel housed within the Department of Public Health, according to a July 23 JD Supra report.
Here are 10 things to know about the new law:
1. New CON Panel. A three-member panel — the commissioner of public health (chair), the secretary of the Office of Policy and Management and the commissioner of social services — replaces OHS as the final decision-maker on CON applications, civil penalties and cease-and-desist orders.
2. Effective dates. The law takes effect Oct. 1, 2026, but most changes become operative July 1, 2027. Applications filed through June 30, 2027 remain under the current OHS process.
3. Expanded ownership definition. Starting Oct. 1, 2026, “change of ownership” broadens to cover mergers, transfers of 25% or more of a facility’s assets, equity or voting shares, governing-board control changes, and real estate deals involving 20% or more of a hospital’s total assets — a shift aimed at increasing scrutiny of private equity-backed transactions.
4. New exemptions. Beginning July 1, 2027, CON approval will no longer be required for termination of certain outpatient surgical services, some Department of Children and Families-funded programs, nonprofit or state-run behavioral health and substance abuse facilities, and relocations within 10 miles that don’t change a facility’s payer mix or patient population.
5. Group practice notice requirement. Large group practice transactions that remain exempt from CON review will still require notice to the CON Program, which must post the information on its website.
6. Streamlined evaluation factors. CON review consolidates to five factors: quality and cost-effective care, access (including for Medicaid beneficiaries), financial stability, demonstrated public need, and avoiding unnecessary duplication of services.
7. New filing deadlines. Starting July 1, 2027, applications must be submitted by the 15th of each month, with a project description posted 21 days in advance and a completeness determination issued within 15 days.
8. Mandatory public hearings. Hearings are required within 90 days of a completed filing unless the applicant waives the right — a waiver that also forfeits the right to appeal. Third parties seeking to intervene face a 20-day notice window.
9. Expedited review pathway. The CON Panel must establish a 60-day expedited process by Jan. 1, 2028 for certain relocations, equipment acquisitions, and operating room or bed additions.
10. Market impact reviews and penalties. Ownership transfers involving for-profit buyers or systems with more than $1 billion in net patient revenue (based on fiscal year 2025) will trigger market impact reviews, and violations of CON rules carry penalties of up to $1,000 per day. Hospitals also gain the ability to pause services for up to 90 days without notifying the CON Program.
The overhaul gives Connecticut hospitals, physician groups and health care investors roughly a year to prepare for a substantially different CON process before the new panel and rules take full effect.
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