The House Committee charged with proposing a legislative reform package for South Carolina’s Certificate of Need (CON) Program is getting closer to making recommendations for the 2015 legislative session. At their last meeting on November 13, Chairman Murrell Smith instructed committee members to use their time over the Thanksgiving break to consider the testimony and resources they had gathered from stakeholders. The committee also includes Republican Representatives Bill Herbkersman and Jim Merrill, as well as Democrats Bill Clyburn and Mike Anthony.
The committee has met three times since Ways and Means Chairman Brian White announced the creation of the panel back in August. The first meeting focused on a review of the current statute and regulations related to CON, as well as a review of the 2012 recommendations of the CON Review Panel appointed by the DHEC Board. At that hearing, DHEC officials acknowledged that increasing the equipment threshold and the issue of grandfathering projects undertaken while the CON program was not enforced were the main impediments to achieving meaningful CON reform last year.
The second hearing provided an opportunity for stakeholders affected by the CON process to share their testimony on how they are impacted by CON, and how it can be improved. Multiple organizations and health care providers presented their position on CON reform, including the SCHA. Some of the key recommendations the SCHA presented to the committee include:
• Removing CON requirements for adding new beds in an existing acute care, rehab or psychiatric hospital when the additions are within the existing footprint of the facility.
• Removing CON requirements for expanding services for which a CON was previously awarded.
• Removing CON requirements for the conversion of acute care beds to psychiatric beds with certain limitations.
• Eliminating the threshold for purchasing medical equipment to be used for diagnoses and treatment. If the threshold is not removed, SCHA recommended raising the threshold.
The most recent committee hearing featured a surprise as DHEC representatives presented their newly proposed regulations submitted to the DHEC Board. Those regulations recommended drastically higher thresholds for obtaining a CON, proposing a $50 million threshold for capital expenditures and a $10 million threshold for medical equipment. This led Chairman Smith to wonder if DHEC’s intention is to amend the CON regulations and State Health Plan to make the CON statute ineffective. “Is this a precursor of what’s going to come from the agency?” asked Smith. Smith agreed that the thresholds must be addressed, but is concerned that the much higher figures would mean that very few expenditures would even fall under the CON review process. The committee is scheduled to reconvene on December 2 when the House returns for an organizational session. To access all of the resources and testimony currently being considered by the House CON Ad Hoc Committee, click here.