State Senate Study Committee Recommends Repealing CON Law

Dave Williams

Wednesday, November 29th, 2023

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A committee made up of Georgia lawmakers, health-care executives, and an insurance industry representative Tuesday recommended repealing the state law governing hospital construction and medical services.

The Senate Study Committee on Certificate of Need (CON) Reform concluded the decades-old CON law is preventing advances in health-care delivery, particularly in rural Georgia.

“Repeal seems to be the most logical conclusion I can draw,” Dr. Steven Wertheim, a former co-president of Resurgens Orthopaedics and a member of the panel, said shortly before the 6-3 vote.

Georgia’s CON law requires applicants wishing to build a new medical facility or provide a new health-care service to demonstrate to the state Department of Community Health that the facility or service is needed in that community.

The General Assembly passed the law in 1979 to comply with a federal mandate aimed at reducing health-care costs by avoiding duplication. However, Congress repealed the federal statute in 1986, leaving the CON issue up to the states.

While most states have retained CON statutes in some form, 11 have done away with their state CON laws, including California and Texas. South Carolina repealed its CON statute last year, with the exception of long-term care facilities.

In Georgia, legislative Republicans have pushed for years to either repeal CON or ease the law’s restrictions.

During this year’s General Assembly session, the Senate took up two bills, one calling for repeal of CON except for long-term care facilities, and the other exempting most rural hospitals from the law. Neither made it past the Senate.

Advocacy groups representing Georgia hospitals have opposed efforts to significantly reform CON or repeal the law entirely. They have argued that for-profit health-care providers would siphon off paying patients from rural hospitals, leaving them in worse financial straits than before.

Acknowledging that repealing CON might be too heavy a lift for the General Assembly, the study committee also recommended a series of reform measures that would stop short of getting rid of the law.

Those fallback recommendations include exempting maternal and neonatal care from going through the CON process. CON exemptions also would apply to medical research centers and to health-care facilities wishing to add new hospital or mental-health beds or expand the number of beds they already provide.

The study committee’s recommendations now move to the full Senate for consideration during the 2024 legislative session starting in January.