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Proposing New CON Barriers-to-Entry
By Staff Reporters
Certificate of Need [CON] laws, regulations, and licensure stipulations are known as Barriers to Entry [B2E] hurdles; and have been removed by many states after decades of utilization. For example Montana, Georgia and others have recently removed them, or currently are critically re-examining their CON laws.
The Mundy Proposal
Pennsylvania State Rep. Phyllis Mundy (D-Luzerne) testified at a recent House Insurance Committee [HIC] hearing on her legislation to re-establish a state Certificate of Need (CON) program for medical equipment as a way to rein in skyrocketing health care costs. Citing the three diagnostic imaging centers near her Kingston home as an example of market saturation, Mundy urged colleagues to require health facilities to justify the need for expensive medical equipment. The Mundy bill also would ban physicians from self-referring patients for procedures at outpatient facilities they have financial interests in, which she said invariably leads to more procedures being done at the facilities.
Purposes and Reasons
According to the September 4thTimes-Tribune, Mundy believes that the proliferation of specialized clinics, imaging centers and surgical centers in communities is one reason health care costs are escalating. Her legislation would re-establish a state regulatory program that was in effect from the 1970s until 1996, requiring a health care facility to apply to the PA State Health Department for a certificate to start or expand services with costly technology.
Assessment
Allied health professionals are increasingly being accepted and recognized by payers and patients as a legitimate alternative to traditional providers and services [more providers equate to more facilities].
And so, can one really wonder about any new legislation to re-establish CON laws that were first in-acted and then disregarded, more than two decade ago. Moreover, is more legislation and health law policy needed, above and beyond Stark I, II and III?
Conclusion
Your thoughts on this dichotomy are appreciated; is it real or perceived; local, regional or national? And, is the aphorism ”doctors would sell Christmas tress if Medicare reimbursed them” true, or even fair. Please opine and comment.
Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Healthcare Organizations: www.HealthcareFinancials.com
Health Administration Terms: www.HealthDictionarySeries.com
Physician Advisors: www.CertifiedMedicalPlanner.com
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Filed under: Career Development, Health Law & Policy, Managed Care, Practice Management, Quality Initiatives | Tagged: B2E, barriers to entry |
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Certificate of Need [CON] Update
[Federal Specialty Hospital Moratorium Ending]
As the Federal Specialty Hospital Moratorium has ended, many states are now moving forward with their own initiatives to prevent market entry of physician-owned facilities through state CON regulations. Despite the original purpose of CON being to control costs, in light of continued evidence refuting CON’s ability to reduce healthcare costs, arguments are now being made to support the use of CON as a way of preventing physician self-referral and supporting the continued viability of community hospitals’ “charity care” policies.
In the April 2007 issue of Health Affairs, for example, Jean Mitchell released findings indicating that physician-owners exploit the exceptions in the Stark law to self-refer patients for diagnostic imaging. Additionally in 2007, Kansas pursued efforts to reinstate CON for specialty hospitals while Montana extended CON for specialty hospitals, with both states citing physician self-referral concerns.
However, not all states seek to use CON to stifle competition from specialty hospitals. For example, in 2009 West Virginia passed legislation which provided several avenues for ambulatory health care facilities to bypass the state’s CON requirements.
Source: Robert James Cmasi MHA, AVA, ABA, CMP™
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