Certificate of Need Resurface in the General Assembly
A bill that would reinstate certificate of need (CON) in Pennsylvania and limit self-referrals has again been introduced in the state House of Representatives.
CON, which requires providers to establish a need before making a major equipment purchase or improvement, was required in the commonwealth more than a decade ago. Opposed by the Pennsylvania Medical Society, CON was eliminated when it was found to be decreasing access to care.
HB 247 would require CON for:
- New or replacement technology costing more than $500,000
- Equipment or facility improvement costing more than $1 million to an ambulatory surgical facility (ASF) or office with clinically reviewable services
- Hospital improvements costing more than $2 million
Applications for CON would need to establish that:
- There is not a more appropriate, less costly, or more effective method of providing the proposed service.
- The proposed service or facility is financially or economically feasible.
- The proposed service or facility will not increase health care costs in the area.
- The proposed service or facility will not limit access to care in medically underserved populations.
The bill also would limit referrals to facilities in which physicians have a financial interest. The Pennsylvania Medical Society opposes this provision because it could delay treatment.
For instance, if a physician determines that a patient needs to be treated in a surgicenter, the physician cannot refer the patient to a center in which the physician has a financial stake.
The patient would have to go to another center, possibly having to switch physicians or travel a great distance.
The House Insurance Committee held a public hearing on the bill on April 23. Another is scheduled for June.
Last Updated: 5/19/2009