A Senate Study Committee on Certificate of Need (CON) Reform in Georgia has confirmed that the original issue the CON laws were meant to address no longer exists. Instead, these laws are being used by established entities in the healthcare market to stifle competition, denying patients the advantages of progress in healthcare delivery, especially in rural areas. Consequently, the committee strongly recommends a full repeal of Georgia’s CON laws.
Their findings, supported by testimonies and research, which included the Georgia Public Policy Foundation, highlight how the CON process obstructs advancements in healthcare and creates anti-competitive environments. To guide potential legislation, the committee recommended South Carolina, which recently repealed nearly all its CON law, as a model.
Should a complete repeal prove unattainable in the upcoming 2024 legislative session, the committee proposes several modifications to the current CON laws. These recommendations include:
- Eliminate CON requirements for Obstetrics Services, Neonatal Intensive Care, Birth Centers, and all services related to Maternal and Neonatal care statewide
- Set a deadline for hospital-based CON to be phased out by January 1, 2025
- Reform CON laws to skip CON review for new and expanded inpatient psychiatric services and beds for Medicaid patients and the uninsured
- Get rid of all cost expenditure triggers for CON
- Consider all medical and surgery specialties as one, including cardiology and general surgery
- Allow Multi-specialty centers, especially in rural areas
- Scrap CON for hospital bed expansion
- Modify freestanding emergency department requirements so they must be within 35 miles of an affiliated hospital and remove CON requirement
- Eliminate CON for research centers
These recommendations aim to encourage competition, enhance healthcare delivery, and address disparities, especially in rural communities. However, the committee emphasizes that a full repeal of the CON laws would be the most effective solution to combat the anti-competitive effects and abuses perpetuated by these laws.
The committee’s evaluation concludes that Georgia’s CON laws, meant to address an outdated problem, now hinder progress in healthcare. The suggested reforms, if enacted, could significantly improve access to advanced healthcare services, particularly in underserved areas, and promote a more competitive healthcare landscape.
Earlier this year, the Foundation published the definitive history of CON in Georgia and overview of the nationwide economic literature about it.
