The certificate of need program is designed to prevent unnecessary duplication of expensive medical services and equipment. In some states the certificate of need process is a two-step process that consists of a Letter of Intent and the Certificate of Need Application. The required elements of such a letter of intent will most likely vary somewhat from state to state.
Letter of Intent in Connection with Obtaining a Certificate of Need for a New Health Care Facility or Major Capital Expenditure in the Health Care Industry
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Description Letter Of Intent For New Health Facility
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Intent Letter Form FAQ
A certificate of need (CON) is a legal document that is required in order to construct a new healthcare facility.
Regulating 28 services, Hawaii has the highest number of CON requirements of any state.Eleven states have no CON laws or caps: California, Colorado, Idaho, Kansas, New Hampshire, North Dakota, Pennsylvania, South Dakota, Texas, Utah, and Wyoming (see the accompanying chart).
As figure 1 shows, Missouri's certificate-of-need program ranks the 21st most restrictive in the United States. Note: Fourteen states either have no certificate-of-need laws or they are not in effect.
THE SOLUTION: Repeal the Certificate of Need law.WHO ELSE DOES IT? California, Colorado, Idaho, Indiana, Kansas, New Hampshire, New Mexico, North Dakota, Pennsylvania, South Dakota, Texas, Utah, and Wyoming have no CON law.
At least 10 statesFlorida, Georgia, Illinois, Maryland, Ohio, Rhode Island, Tennessee, Vermont, Virginia and Washingtonenacted legislation in 2019 to modify CON oversight for certain health facilities and services.
Kentucky remains among the 36 states, along with the District of Columbia, that continue to limit entry and expansion within their respective health care markets through certificates of need. On average, states with CON programs regulate 14 different services, devices, and procedures.
The State of Oklahoma requires facilities to obtain a certificate of need before developing or changing long-term care and psychiatric/chemical dependency services.
The program stopped providing funds in 1997, but about 140 health care facilities nationwide are still obligated to provide free or reduced-cost care.Since 1980, more than $6 billion in uncompensated services have been provided to eligible patients through Hill-Burton.
At least 10 statesFlorida, Georgia, Illinois, Maryland, Ohio, Rhode Island, Tennessee, Vermont, Virginia and Washingtonenacted legislation in 2019 to modify CON oversight for certain health facilities and services.