Local lawmakers call for end of Certificate of Need process
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JONESBOROUGH, Tenn. (WJHL) — Three Northeast Tennessee lawmakers publicly called for the end of the state’s certificate of need certificate of need law, after passing reforms this legislative session.
State Representatives David Hawk (R-Greeneville), Timothy Hill (R-Bloutnville) and Bud Hulsey (R-Kingsport) answered healthcare policy questions as part of an Americans for Prosperity-hosted panel Saturday. The event focused primarily on the certificates of need (CON) process, a state review pipeline that is required to open most healthcare facilities in the state.
Opening the event, Hawk highlighted both the CON reform the legislature passed this session and his hopes for the policy’s future.
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“For our region of Tennessee, it’s critically important that the certificate need be scaled back and eventually be repealed because there are some lack of services, there are some thoughts that we need other options in our region and the ability to to find care,” Hawk said.
The legislature is already working to scale back the CON process, passing a bill that will allow some medical facilities, including certain satellite emergency departments, to open without receiving a CON.
An earlier version of the bill would have loosened those rules making it easier for competitors to open hospitals in Ballad Health’s services area. That portion of the bill was eliminated prior to its passage.
Ballad leaders told News Channel 11 in a statement that they were pleased with the version of the bill that passed.
“Ultimately, the legislature has, for multiple years, debated and passed thoughtful reforms to CON, all with our support,” said Ballad CEO Alan Levine. “We were happy to support this year’s changes, and we think the legislature thoughtfully considered what would happen in rural regions if safety net hospitals were to fail. “
Hawk and his colleagues argue that ending CON entirely would improve healthcare in the region by making room for more competition.
“We need some changes across the state of Tennessee in the way the certificate of need is drawn to allow our citizens with their health care patients to go see their doctors in whatever hospital setting may they desire necessary,” Hawk told News Channel 11.
Ballad has successfully lobbied the state for the ability to oppose new healthcare facilities as part of the CON process; however, Levine said in an email that no organizations have applied to build a new hospital since it was granted a monopoly in 2018.
When asked whether the system would approve a total repeal of the CON process, Levine said, in part:
“As with any proposed legislation, we would have to make sure the public understands the benefits and possible consequences of whatever is proposed. One thing we do know is that our communities would prefer to see their hospitals remain open. And we would support efforts to make sure that happens.”
– Alan Levine, CEO, Ballad Health
Neither Hawk nor Hulsey called for a complete end to Ballad’s COPA, despite their assertions that healthcare in the region could be improved.
Ballad’s monopoly was granted through a “Certificate of Public Advantage” (COPA), which shielded Ballad from federal antitrust lawsuits provided that it met certain conditions.
“I want Ballad to succeed because I don’t know what our alternatives are,” Hulsey told the crowd.
Still, Hawk asserts that creating room for competition is the path to improvement.
“In theory, if you disband the COPA today, you might have no hospital to go to tomorrow,” Hawk said. So there needs to continue to be a safety net there, but also the ability to allow other health care professionals to come into the region, start a hospital, or start one of these hospitals or medical services.”
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