Certificate-of-need has become one of the most contentious policy discussions in the ASC space as both physicians and federal agencies putting increased pressure on states to reform and repeal these regulations.
Here’s where three different state CON policies stand now:
1. Lawmakers in North Carolina advanced legislation that would repeal parts of the state’s CON law. Senate Bill 1040 cleared the state Senate Health Committee earlier in May. The bill would eliminate CON requirements for ASCs across the state and remove the approval process for inpatient rehabilitation facilities.
The bill expands upon a 2023 proposal that first loosened restrictions in the state, according to the report. If approved, the first major changes would take effect July 1.
The repeal could have significant impacts in a state that has a highly competitive healthcare industry and has seen waves of other legal actions aimed at repeating CON.
2. Tennessee governor Bill Lee signed legislation eliminating CON requirements for new acute care hospitals, satellite emergency departments and cardiac catheterization services May 6.
The new law comes after months of controversy surrounding the state legislature’s long-awaited dismantling of CON. Those delays were addressed in an April 1 letter from the Federal Trade Commission addressed to Representative David Hawk,a Republican from Greeneville. The letter urged the Tennessee General Assembly to repeal CON laws “as soon as possible.”
Tennessee’s bid for funding as a part of the federal Rural Health Transformation program has been hanging in the balance of CON reform as CMS and President Donald Trump’s administration have tied some of that funding to certain policies at the state level, including the elimination of CON, according to a summary of the RHT published by the American Medical Association in September. Tennessee has had plans to repeal the 40-year-old law by Dec. 1, 2027, since 2024.
3. Michigan lawmakers are weighing legislation that would eliminate hospital outpatient facility fees and loosen certificate-of-need requirements for imaging services. House Bill 5709 would eliminate CON requirements for certain imaging services at outpatient centers, and lawmakers are still deliberating the shift.
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