House proposes changes to Mississippi CON laws with goal of improving medical access, reducing regulatory burden

• Birthing centers, chemical dependency facilities, and more could be exempted from CON under the legislation approved by a bipartisan vote in the House this week.

A bill that passed in the Mississippi House of Representatives this week would roll back the requirement for a Certificate of Need (CON) for a variety of healthcare services. It would also increase the minimum dollar amount of capital expenditures that trigger a CON being required.

CON laws require medical facilities to obtain government permission before opening, expanding, or purchasing new medical equipment. An application is submitted to the Department of Health which reviews the proposal to determine if the new facility or equipment is needed in a specific community. However, existing providers in the area are allowed to oppose the application, causing many CON reform advocates to claim that the practice is anti-competitive.

Legislation filed by State Rep. Hank Zuber (R) – HB 922 – would remove birthing centers, chemical dependency facilities, intermediate care facilities, and psychiatric care residential treatment facilities from the CON process upon the Governor’s signature. In addition, after July 1, 2029, hospital-based dialysis facilities, MRI services, and invasive diagnostic imaging services would be exempted from the CON process.

The move is aimed at improving access and investment in these services without the regulatory burden of the CON process.

RELATED: Certificate of Need laws stifling Mississippi’s healthcare system?

State Rep. Samuel Creekmore (R), co-author of the legislation and chairman of the House Public Health and Human Services Committee, told members that the bill increases the threshold for a CON in the three categories of capital expenditures.

“For being major medical equipment. It raises it from $1.5 million to $3 million. Clinical health services, raises the capital expenditures from $5 million to $10 million. And nonclinical health services is increased from $10 million to $20 million,” Creekmore said.

This bill will also streamlines the appeals process, Rep. Creekmore said.

“In the event that the Department of Health denies a CON, then you can appeal the CON through a special chancery judge which will be appointed by the Supreme Court. The Supreme Court will have 15 days to appoint that judge, and the judge will have 120 days to make a decision, and that decision will be final,” Creekmore described.

Intermediate care facilities and individuals with intellectual disabilities facilities remain in CON.

When a facility applies for and is approved for a CON, it is good for 12 months under the bill. If no progress has been made in the period, the CON will be revoked. However, if progress is being made but is not complete, an application can be submitted for a 12-month extension up to four times for a total of 5 years, as long as progress is being made. 

“At the same time the Department of Health can revoke your CON when they see there’s no progress anytime during that five-year period,” Creekmore added.

Creekmore also noted that the legislation impacts data storage timelines for the state health plan. Currently, Mississippi’s data under the state health plan is stored for three years. This bill limits the storage of that data for within the previous 12 months. 

“As far as the state health plan, we mandated that they use current data, that’s a good thing,” Creekmore described.

State Rep. Omeria Scott (D) spoke on the bill to express her concern with adjusting the CON laws, saying the proposed changes would result in increased costs to the state by drawing in more Medicaid recipients.

Creekmore countered that Scott’s concerns are unfounded in relation to the legislation. 

“I can tell you right now this CON bill won’t cost the state a dime, it doesn’t cost anything to take services and facilities out of Certificate of Need,” Creekmore elaborated.

He went on to describe that Certificate of Need became a mandate of the federal government in the 1970s with the intention of keeping healthcare costs down. Yet, the move did not work as planned and the federal mandate was lifted in the 1980s, instead leaving it up to the states. Mississippi was one of the states that kept their CON laws in place. Rep. Creekmore went on to say that CON has matured over the years, and as a result, some of those services have aged out of the need for such laws.

The bill overwhelmingly passed the House floor in a bipartisan vote of 107-5. It now moves to the Senate for consideration.