W.Va.'s certificate-of-need process drives providers away
06/03/2013 - Charleston Daily Mail
CHARLESTON - Ever wonder why so many West Virginia health providers are leaving our state to locate in a
The answer is that a restrictive medical certificate of need is required by West Virginia and not
in our bordering states.
What is a certificate of need?
In 197 4 a federal law required that all states have structures involving the submission of
proposals and that all providers obtain approval from a state health planning agency before
beginning any major expansion or ordering new high-tech devices.
Until 1986, the federal government required all states to have certificate-of-need programs to
receive federal Medicaid funding. The certificate required a designated state agency 's
approval of the expansion of new medical facilities or equipment in excess of a certain dollar
In West Virginia, this state agency is the Health Care Authority . The agency was originated in
1977. The stated purpose of the agency is to control health care costs, improve efficiency in
the health care sy stem, and develop health care delivery that will benefit all residents of the
No certificate is issued unless the state determines a public need for the project, service or
Many health care providers object to the restrictive nature of the certification process. It has
become a fight between hospitals, which have the financial resources to comply with
mandates of the Health Care Authority , and small health care providers that seek to meet
In 2007 , the Legislature was involved in debate over whether or not to loosen the restrictive
requirements. In the state Senate, the debate became one between a doctor with a small rural
practice and a doctor who worked at the large Charleston Area Medical Center.
This debate resulted in little change in the requirements. In a more recent legislative session,
House members were told that cumbersome requirements were contributing to a shortage of
in-home personal care providers.
Evan Jenkins, a state senator and executive director of the state Medical Association, has said
that West Virginia has one of the most restrictive CON laws in the country .
West Virginia is out of step because of our restrictive environment. We should become more
like other states and do away with or reduce our CON oversight.