Florida Removes Certificate of Need Laws

Published May 24, 2019

      An agreement between the Florida House and Senate came at the very end of the 2019 session with Senate approval of H.B. 21with some modifications. Speaker of the House Jose Oliva (R-Miami) had been pushing for complete repeal of the state’s CON laws, but Senate support for the idea proved insufficient. A modified version, S.B. 1712, met resistance from reformers and opponents alike.

     Ultimately, lawmakers agreed to eliminate CON for new general hospitals and tertiary services such as organ transplants, but nursing homes, hospice programs, and “boutique” facilities such as cancer care and orthopedic hospitals will still require CON approval. The final bill passed overwhelmingly in the Florida House, and Gov. Ron DeSantis is expected to sign the bill which is scheduled to go into effect July 1. 

     Bills to eliminate CON have been introduced before in Florida, especially over the past few years, but never gained traction until now.

     “Rolling back Florida’s certificate of need laws is a tremendous accomplishment for the Florida legislature,” said Matt Glans, a senior policy analyst with The Heartland Institute, which publishes Health Care News. “CON laws are an outdated mechanism which far too often devolve into crony capitalism and indulge certain providers with special treatment over the good of the market.”

Most States Impose Restrictions

Florida is one of 35 states with CON laws. This year, Alaska, Georgia, Missouri, South Carolina, and Tennessee were among those considering CON reform.

     Repeal can be challenging. Several high-profile projects in Florida had been thwarted by the state’s CON board, including two hospitals requesting permission to perform pediatric heart transplants. Currently, two hospitals are trying to establish adult bone marrow transplant programs. CON laws require facilities to demonstrate an unmet need before expanding or entering new markets, thus thwarting improvement of services and expansion of access.

     The U.S. Department of Health and Human Services has encouraged states to eliminate CON laws, which came into existence in 1974 when the federal government required them in return for federal funding. Over the years, opinion on CON has changed, with presidents from both parties favoring repeal.

     “Eliminating these unnecessary barriers will unleash competition, thus producing myriad choices and innovations that will benefit all health care consumers,” said Glans. “Without CON laws, more medical facilities will be built, and additional procedures will be offered in Florida, allowing for new and existing patient services to be met in a convenient, reliable, affordable, and timely manner.”

AnneMarie Schieber ([email protected])is managing editor of Health Care News.