Certificate of Need

U.S. DoJ slams CON laws

Anne Zieger — Mon, 15 Sep 2008 10:13:48 -0400

This week, officials from the U.S. Department of Justice are expected to tell Illinois officials what they've told officials in other states--that they think CON laws are best eliminated. Both the U.S. DoJ and the Federal Trade Commission have told officials in other states, including Florida and Alaska, that such laws aren't a good idea, as they lessen consumer choice, slow innovation and weaken markets' cost-cutting abilities. They note that most CON laws were drafted as a response to a 1974 federal law, which has since repealed, which offered states incentives to establish CON regs.

CON activity is even more suspect in Illinois, where there's been questions about how it was run. The panel that administers the program, the Illinois Health Facilities Planning Board, has been under scrutiny since 2004, when it was discovered that a member set up a system of kickbacks for himself in exchange for approval votes. Since then, the state's CON law has been renewed several times. Now, a task force evaluating the legislation has been asked to make a recommendation as to whether the law should be renewed.

To find out more about the CON evaluation process in IL:
- read this Modern Healthcare article (reg. req.)

Related Articles:
FL, IA legislatures pass CON reforms
FL governor wants to end CON law
GA to revamp CON system
AL study questions need for CON process

Prosecutors fight to uphold Scrushy bribery conviction

Anne Zieger — Wed, 06 Aug 2008 09:53:30 -0400

Federal prosecutors are battling to uphold the convictions of HealthSouth founder Richard Scrushy--and former Alabama Governor Don Siegelman--on bribery, conspiracy and mail fraud charges in appeals court. The defense is arguing that the convictions should be overturned because the jury was tainted, citing e-mails allegedly sent by jurors who discussed the case and pressured another juror for a guilty verdict.

Federal prosecutors, meanwhile, contend that if they did the in-depth examination required to determine the authenticity of the e-mails, which would include a search of juror hard drives and BlackBerries, it would verge on juror harassment and could impact their ability to empanel future juries. (That being said, U.S. postal inspectors previously investigated who sent the e-mails, and concluded that they were fakes.)

Scrushy and Siegelman were convicted on charges that the former HealthSouth CEO bought a seat on the state's Certificate of Need Review Board by donating $500,000 to Siegelman's lottery campaign. While Siegelman is free on an appeal bond, Scrushy has been in prison for more than a year.

To learn more about the appeal:
- read this article from The Birmingham News

Related Articles:
Scrushy found guilty of fraud charges
HealthSouth's Scrushy going to jail
Scrushy ordered to repay $51.5M

Federal spending bill could limit physician hospital ownership

Wed, 04 Jun 2008 06:59:57 -0400

A group of Republican Congress members are raising objections to language in a war supplemental spending bill that they say would harm physician-owned hospitals. Sens. Jon Kyl (R-AZ) and Tom Coburn (R-OK), along with Texas republican Reps. Sam Johnson and Joe Barton, object to an amendment that would prohibit new physician owned hospitals built after this coming September, while offering no protection for hospitals still under development as of that date. They're also unhappy about rules that would force hospitals to meet what they deem "extreme qualifications" to expand, rather than grow as they see fit. In a letter to the Senate Appropriations Committee, the legislators call these provisions "a national certificate-of-need program... access to [which] would likely be denied to almost every physician-owned hospital."

To learn more about the legislators' challenge to physician-owned hospital regs:
- read this Modern Healthcare piece

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FL gov. signs law reforming CON rules

Tue, 20 May 2008 06:59:56 -0400

Florida Gov. Charlie Crist (R) has signed a bill, strongly backed by the state's hospital association, which remakes the state's certificate-of-need process. The bill includes a "loser pays" rule that covers a hospital's legal fees if there's an unsuccessful appeal after the state has granted a CON. Under the terms of the provision, parties that appeal a CON decision must post a $1 million bond and cover the other party's legal costs if they lose their appeal.

In evaluating need, the revised rules will focus more than they have in the past on the extent to which a facility impacts access and competition, and how that facility will service indigent and Medicaid patients--as well as completing the analysis more rapidly.

To learn more about Florida's CON law changes:
- read this Modern Healthcare article (reg. req.)

Related Articles:
FL, IA legislatures pass CON reforms
FL governor wants to end CON law
GA to revamp CON system
Al study questions need for CON process

FL, IA legislatures pass CON reforms

Tue, 06 May 2008 06:59:56 -0400

Picking up on a trend that seems to be mounting nationwide, Florida and Iowa legislators have passed bills that will reform their respective certificate-of-need processes. Fulfilling one of his often-stated goals, Florida Governor Charlie Crist (R) plans to sign the legislation, which not only simplifies the process, but also includes a "loser pays" section that tries to discourage lawsuits designed to delay the launch of a new facilities.

Meanwhile, Iowa's CON legislation may or may not pass, as Gov. Chet Culver (D) hasn't said where he stands. Passing CON reforms there is complicated by the fact that the reforms are buried in a larger bill that addresses varied financing and policy issues. The bill would let replacement critical-access hospitals serving 75 percent of the same area, providing 75 percent of the same services and keeping 75 percent of the same staff avoid the CON process entirely.

To learn more about these bills:
- read this Modern Healthcare article

Related Articles:
IA bill exempts some hospitals from CON process
FL governor wants to end CON law
GA may approve sweeping CON changes
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IA bill exempts some hospitals from CON process

Mon, 05 May 2008 06:59:55 -0400

Iowa lawmakers have approved a bill that would strike down the state's certificate of need rules, at least as they apply to the state's 82 small, rural hospitals. The bill, which certainly makes the state's hospitals happy, includes language similar to that in a proposal issued by the Iowa Hospital Association. State legislators who shepherded the bill through Iowa's legislature have argued that the CON process is unduly burdensome for small hospitals. The bill is still subject to a veto from the state's governor, and it's not clear whether he'll sign it or not. At present, there's still some controversy over the nature of the bill's passage, which apparently got through without much public attention. However, a growing number of states have already limited or removed CON rules, so there is precedent for this measure.

To learn more about the Iowa CON bill:
- read this Associated Press item

Related Articles:
FL governor wants to end CON law
GA may approve sweeping CON changes
AL study questions need for CON process
RI reviews med equipment CON process

GA may approve sweeping CON changes

Wed, 02 Apr 2008 07:59:56 -0400

Georgia seems well on its way to approving a new bill that would remove most of the state's Certificate of Need restrictions. The state House of Representatives is considering a measure, championed by a few legislators, which would help general surgeons open ambulatory surgery centers. It also would let hospitals build parking decks and other non-clinical projects without state permission and lift obstetrics restrictions on some hospitals, as well as allowing more hospitals to perform heart procedures like diagnostic catheterizations. If passed, the bill would institute the biggest changes in the CON system since it was enacted more than 25 years ago.

Despite gifts to the hospital industry, some hospital officials remain in opposition. They're uncomfortable with a few facets of the bill, particularly the ambulatory surgery changes. Their lobbyists argue that the bill would give the ASCs an unfair advantage. Other hospital groups, including rural hospitals, are in favor of its passage.

To learn more about the CON changes:
- read this Atlanta Journal-Constitution piece

Related Articles:
FL governor wants to end CON law. Report
AL study questions need for CON process. Article
GA physicians battle for looser ASC regs. Report
GA to revamp CON system. Report