Lawmakers agree WVa ‘Certificate of Need’ laws need reform
CHARLESTON, W.Va. (AP) — Multiple proposals that would have either repealed or significantly scaled back the “Certificate of Need” requirement for health care services in West Virginia were voted down Tuesday during an hourslong debate on the House floor.
Lawmakers were split on removing the requirement, with around 60% voting consistently against the proposals and 40% in favor. But delegates on both sides said that the decades-old system is in need of reform.
“There are some uncertainties, but one thing that is certain is that the system we have is not working,” said Republican Del. Dana Ferrell, who spoke in favor of repealing some Certificate of Need requirements.
Since 1977, most West Virginia health care providers that want to open or expand facilities must obtain a “Certificate of Need.” The process is overseen by the state’s Health Care Authority. To acquire a Certificate of Need, facilities must prove that their community needs the proposed service.
The purpose is to regulate the health care market to discourage unnecessary duplication of services. However, some lawmakers and advocates have asserted in recent years that the process — which can cost providers tens of thousands of dollars — actually creates more barriers to care. They claim it protects existing providers from competition more than it protects patients.
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Republican Del. Heather Tully called the Certificate of Need “a competitor’s veto.”
“It is heavily influenced by political relationships, providers’ clout, organization size, overall wealth and resources, rather than sound policies, objectives and concern for patients,” she said.
Republican Del. Joe Jeffries agreed, saying that it limits consumer choice and stifles innovation in the health care field.
“I don’t think there’s one member on this floor that hasn’t heard from constituents about not having decent health care options in this state,” he said. “We need to bring the competition to the state.”
A bill that would have repealed the Certificate of Need requirement failed earlier this month in the House Health and Human Resources Committee after five hours of discussion and debate.
The proposals being discussed Tuesday that would have repealed some requirements were amendments to a different bill. Among the amendments was one that would have repealed the Certificate of Need requirements except for nursing homes, intermediate care facility beds, hospice, home health, and personal services. Another would have excluded a Certificate of Need process from birthing centers and all existing hospitals.
Republican Del. Matthew Rohrbach, chair of the House Health and Human Resources Committee, spoke against Tuesday’s proposals, but he said the system is “antiquated and ”has to change” and be updated.
“Yes, the Certificate of Need needs change, there’s no question about that — that came across loud and clear,” he said. “Will we do that with a sledgehammer and just blow it up today and see where the pieces fall? ... I would challenge there is a better way, a more thoughtful way.”
Republican Del. Ken Reed agreed. He said the Legislature should be having serious conversations about updating the requirements, but that it’s a process that requires more time and discussion.
“We’re trying to push something through that’s going to cause a ripple effect in the marketplace going forward and just with the pandemic going on, I just don’t think that’s a wise thing to do at this point,” he said. “I just do not think this is the right time to push that boulder over a cliff because you just don’t know where it’s going to land.”