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Senate puts hospital certificate of need reforms in budget

Long-discussed changes in the way hospitals work will be part of state budget negotiations.

Posted Updated
N.C. health, mental health, Medicaid generic
By
Travis Fain
, WRAL statehouse reporter
RALEIGH, N.C. — Senate leaders put significant changes in the way North Carolina regulates hospitals into the budget proposal they released Tuesday, ensuring that a long-running debate over Certificate of Need reform will be part of coming negotiations.

The language would exempt ambulatory surgery facilities, operating rooms, kidney treatment centers, psychiatric hospitals and other mental health facilities from a law requiring state approval to open such facilities. The proposal is similar to Senate Bill 646.

Hospitals have long fought rollbacks of the state's Certificate of Need program, fearing reforms would allow doctors to split off profitable services and leave hospitals struggling to offset costs from their emergency rooms.

The ambulatory surgery center proposal, in particular, generates pushback. Reform supporters say they want to see more of a free market in the health care sector. The state's CON rules date back decades and were meant to foster the right number of hospitals and other facilities around the state.

Just because this language is in the Senate budget doesn't mean it will happen. The House did not include it in its budget proposal, and Gov. Roy Cooper will have a say in the final budget as well.

The provision is a scaled-back effort compared to past Senate efforts, which called for a full CON repeal in previous budget proposals.

"This is more of a consensus view of what needs to change," said state Sen. Ralph Hise, R-Mitchell, a chamber leader on health issues and a long-time advocate for CON reform.

In addition to splitting some services out of the CON rules, the proposal would require groups that win a Certificate of Need to complete their project within two years or lose the certificate. This would prevent hoarding, Hise said.

The language also changes the rules for appealing a CON decision by state regulators. Among other things, it would allow only groups that bid on a certificate to appeal the decision.

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