CON Reform Plan Is At Hand

November 22, 2002
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LANSING — A West Michigan legislator who has spent the year examining Michigan’s certificate of need program is confident some form of a reform package will clear the Legislature yet this year, although probably not in the form of a bill that earned Senate passage last week.

State Rep. Barbara VanderVeen, R-Allendale, plans to introduce a substitute bill in the House when lawmakers reconvene in December. VanderVeen expects her version to win passage in the House and a final CON reform proposal to come out of a House-Senate conference committee during a 10-day session of the lame-duck Legislature in December.

“I think we’re going to have some good revisions,” said VanderVeen, who chairs a subcommittee of the House Health Policy Committee that has been examining CON.

Certificate of need requires hospitals and health care providers to justify a market demand before they may initiate certain clinical services and undertake major capital improvements. The goal is to prevent the costly duplication of medical services.

CON has come under attack in the past year by some who view it as a poorly run program that’s become costly and burdensome and stifles competition.

The state Senate last week passed a bill sponsored by Sen. John Schwarz, R-Battle Creek, that would make some changes in the CON process, although not as many as proposed when the measured was introduced last month.

The bill, passed Nov. 18 on a 24-11 vote, would abolish the present ad-hoc committee structure by which CON standards used to evaluate health care projects are formulated. The CON Commission would grow from five to nine members, with representation from varying health care interests, and receive the authority to hire outside expertise to help develop new standards.

VanderVeen said her version would likely restore the ad-hoc process and refine how committee members are appointed. She also wants to increase legislative oversight of CON through subcommittees formed under the House and Senate health policy committees.

MRI scanners, which would have been exempt from CON review under Schwarz’s original bill, would fall under new provisions that automatically allow a minimum of two fixed MRIs in counties with a population of 150,000 or more.

Critics in the past have often cited long delays of up to three to four weeks to have an MRI in Michigan as an example of the program’s ineffectiveness. With changes in state standards for MRIs earlier this year to substantially increase the number of devices deployed throughout the state, those delays have been quickly easing.

The Senate bill would also raise the threshold where a CON is required from $2 million to $2.5 million for a capital improvement project or equipment purchase related to a clinical procedure, and from $3 million to $5 million for a nonclinical service.

Gone from the original bill is the transfer of CON’s administration from the Department of Community Health to the Department of Consumer and Industry Services.

In preparing a House version of the bill, VanderVeen plans to focus on those reforms that can win final approval.

“My goal is to do what we can realistically do,” she said.

Legislators can take up any further reforms next year, she said.           

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