News: Quick Takes

Clock running out on certificate-of-need reform for 2017 NCGA session

Certificate-of-need reforms were left out of the final budget compromise passed by the General Assembly.

But backers aren’t giving up on curtailing or ending the regulation that forces medical providers to get permission from the government to make major new investments.

Sen. Ralph Hise, R-Mitchell, successfully inserted a phased-in repeal of the state’s certificate of need system into the Senate budget. A number of other, more narrowly targeted repeals of the CON law also were included in the Senate budget. The budget conference committee stripped the reforms from the spending plan.

Hise also was able to get CON repeal added to the Senate version of the budget in 2015. Both times he has been frustrated with the House refusing to agree to the reform.

North Carolina is the fourth most heavily regulated state for CON, which requires state approval to purchase large medical equipment, to set up freestanding surgical clinics, and for a host of other medical procedures. A growing body of research shows medical coverage costs more and is more difficult to get in states with heavy CON restrictions.

“It’s interesting to see in specific cases everybody understands where it needs to go away, but the overall concept, in the final decision, it wasn’t there,” Hise said.

“We believe that that is a major policy issue that is best addressed through the normal legislative process, and the normal committees outside of negotiation in the budget process,” Rep. Nelson Dollar, R-Wake, the House chief budget writer, said when asked previously why the House version of the budget did not include CON repeal.

In last year’s short legislative session CON reform was adopted through the budget process. Psychiatric facilities created with money from the sale of Dorothea Dix Hospital were exempted from the CON program.

“We are pleased that the budget introduced by lawmakers this week does not include repeal of the state’s certificate of need law, and thankful to those who worked to keep this important law in place,” said Julie Henry, spokeswoman for the North Carolina Hospital Association, which has formed a political organization focusing on opposing CON repeal, among other matters.

“In light of the continued uncertainty about federal changes to the healthcare delivery system, coupled with the numerous mandates that the federal government places on hospitals, it is critical that our state officials focus on preserving the health care safety net that hospitals and health systems provide to our communities,” Henry said.

“I don’t know if I’ll wait till next year, but I ain’t done fighting,” Hise said.

Hise wouldn’t say if the Senate would take up House-passed H.B. 657 before the end of the session, and amended to include more CON reform. H.B. 657 would exempt new owners of an adult home care facility from the CON permitting process in certain circumstances.