Certificate of Need reform bill vetoed by Governor back before lawmakers

• State Rep. Samuel Creekmore believes he has the cooperation from the Senate needed to send the bill back to the governor’s desk minus the provisions that caused the veto.

A bill that would have revamped Mississippi’s certificate of need laws but was vetoed by the governor last year has been reintroduced in the House of Representatives.

On Wednesday, the House Public Health and Human Services Committee took up a similar bill, HB 3, passing it on for later consideration on the House floor.

Public Health and Human Services Committee Chair State Rep. Samuel Creekmore (R) said the bill is essentially the same as last year’s, except it addresses the issues raised by Governor Tate Reeves (R) in the amendment from the Senate.

“In his opinion there was one part of the language that he didn’t agree with, that has been taken out of this bill,” Creekmore said. 

The change in question allowed Oceans Healthcare to provide psychiatric care at St. Dominics. Merit Health filed a lawsuit to prevent the reopening of St. Dominic behavioral health center, leaving Merit as the only provider in that field in the central part of the state. Merit’s contention was that Oceans did not have to go through the CON process because taking over the existing facility was considered a “change of ownership,” and therefore did not require a new certificate of need. 

Governor Reeves said at the time of his veto that while he commended the Mississippi Legislature’s attempt to achieve much needed and long overdue CON reform, “the addition of an eleventh-hour floor amendment that violates the doctrine of separation of powers and is bad public policy requires me to veto House Bill 569 at this time.”

He added in the veto message that if the bill was returned to his desk without the language in question that he would sign it into law.

The new version of the bill has several parts. The first focuses on three facilities in Desoto County, a 40-bed psychiatric treatment facility in Madison County, and CONs for community living for developmentally disabled adults. It also allows a long-term care hospital in Harrison County to participate in Medicaid as a crossover provider for Medicare, Creekmore explained. 

The second part of the bill concerns academic exemptions at the University of Mississippi Medical Center.

“In this bill, it limits the academic exemption to just the main campus,” Creekmore said. “Currently, UMMC has academic exemptions at all other sites throughout the state. This will limit it to just the main campus here in Jackson.”

The third part of the bill directs the Department of Health to conduct a study on CON exemptions for small hospitals.

“This is only a study, this does not affect CON law,” Creekmore added. 

A report based on that study is due back to the Legislature by December 1 of this year. The study would focus on whether to allow the establishment of dialysis units in hospitals and will have a separate focus on acute adult psychiatric care. 

“Specifically, should private facilities treat a percentage of uninsured patients and/or pay a periodic fee in lieu of charity care for facilities that do treat uninsured patients,” Creekmore said. 

The bill also brings back increases on capital expenditure caps related to CON applications. For clinical capital expenditures, the bill proposes to increase the requirement for a CON application from $5 million to $10 million, non-clinical expenditures will move from the current limit of $10 million to $20 million, and major medical will move from its current cap of $1.5 million to $3 million. 

Creekmore added that should this bill make it out of the House and Senate, it would be effective upon passage.

“I do have, as of this morning, cooperation from the Senate that they will take this up as soon as possible to get this over to the governor,” Creekmore said. 

The measure passed out of the House Public Health and Human Services Committee and was sent to the House State Affair Committee, as it was double referred.