ATLANTA – After years of nibbling around the edges of regulations governing how Georgia hospitals operate, the General Assembly may decide to scrap the Certificate of Need (CON) law altogether.
A state House committee approved legislation late last week that would repeal CON by 2025. It could hit the House floor on Tuesday, the Crossover Day deadline for bills to pass at least one legislative chamber to remain alive for the year.
The 1979 CON law requires applicants wishing to build a new medical facility or provide new health-care services in Georgia to show it is needed in their communities. It was enacted to comply with a federal mandate aimed at reducing health-care costs by avoiding duplication.
Instead, the law has increased the costs of care by stifling competition, House Majority Whip Matt Hatchett, R-Dublin, the bill’s chief sponsor, told members of the House Special Committee on Access to Quality Health Care.
“We’ve allowed our large hospitals to become monopolies in their communities and continue to raise prices,” he said. “The large hospitals get larger, and our small hospitals continue to struggle to survive.”
The General Assembly has reformed the CON law over the years. In 2008, lawmakers exempted physician-owned ambulatory surgery centers with a single specialty from having to obtain a CON.
In 2013, the legislature limited the filing of objections to CON applications to existing hospitals within 35 miles of a new facility seeking a certificate of need.
House Bill 1547 would repeal CON as of Jan. 1, 2025, and replace it with a licensing program with the same indigent care requirements that now apply to CON applicants.
During the two years leading up to the repeal taking effect, the legislation would give multiple-specialty surgery centers the same exemption now provided single-specialty centers.
It also would limit cash reserves nonprofit hospitals would be allowed to maintain and create a new state program to aid uninsured mental health patients.
Opposition to the bill is led by organizations representing Georgia hospitals.
Monty Veazey, president and CEO of the Tifton-based Georgia Alliance of Community Hospitals, said repealing the CON law would devastate an industry already struggling to emerge from COVID-19 and saddled with a severe shortage of health-care workers, particularly nurses.
“This bill comes at the worst time for us,” he said. “Across the state, hospitals are losing millions of dollars. … When you repeal CON and allow ASCs (ambulatory surgery centers) to proliferate, it just draws paying patients from hospitals.”
Some committee members argued the CON law needs reforming but shouldn’t be repealed.
“I don’t think the answer to the CON issue is to totally eliminate it,” said Rep. Butch Parrish, R-Swainsboro.
But Rep. Sharon Cooper, R-Marietta, said the years of opposition the hospital industry and its hired lobbyists have mounted to reforming CON have convinced some lawmakers it’s time to scrap the process.
“Any time you try to get even minor changes, the answer is always, ‘No,’ ” she said. “That’s the frustration all of us are feeling. … I’m sick of it.”
This story is available through a news partnership with Capitol Beat News Service, a project of the Georgia Press Educational Foundation.