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Certificate-of-need laws: Where ASC leaders stand

Patty Newitt – Monday, June 26th, 2023


Thirty-four states in the U.S. currently have certificate-of-need laws that govern where health systems can build new facilities, including ASCs, based on demonstrated need in an area.

Several states — including Georgia, Mississippi and North Carolina — have proposed legislation that would repeal or fix CON regulations, making it easier for ASCs to spread throughout states.

Here is what three key ASC leaders have told Becker’s about where they stand on certificate-of-need laws, and which way laws might be moving.

“There are still many states that have pretty restrictive certificate-of-need laws. It would just be a huge gold rush and avenue for lowering healthcare costs if governments could give these physicians an opportunity. There’s really only 20 percent of these physicians who are entrepreneurial, who understand the business aspect of running these facilities and take the risk. We have an aging physician population, but we also have new physicians. We’ve been doing this so long that we’re doing the ASCs for the sons whose fathers have now retired or are on the verge of retiring.

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“Another main driver is certificate-of-need laws are starting to get relaxed. So in a lot of states like Tennessee and North Carolina and Alabama and New York, their CON laws have been so restrictive and finally governments have figured out that they’ve got to give them access to healthcare. Hospitals have done a great job of lobbying the state legislatures and getting laws implemented that make it extremely difficult or extremely expensive and time consuming to even go through the CON process.

We’re now getting a batch of physicians now who are realizing they have an opportunity now to go into a surgery center.” – Philip Blair, CEO of Surgery Center Services of America (Mesa, Ariz.)

“Most positively, I think these items will disrupt the ASC industry next … Implementation of value-based care and stringent certificate-of-need law states will have to adapt to lower the healthcare costs.” – Raghu Reddy, chief administrative officer of SurgCenter of Western Maryland (Cumberland)

“Physician-owned or operated ASCs in Oklahoma, Texas, Kansas and Arkansas have been the result of robust entrepreneurial growth over the years coupled with very little restraints of certificate-of-need statutes and regulatory oversight. The result early on was a plethora of ASCs as outpatient surgery grew in popularity, and many physician-owned entities were built in areas one would never have imagined.” – Stewart Burchett, executive director of Oklahoma Lithotripter Associates and Oklahoma Kidney Stone Center (Oklahoma City)


Read this article and more articles from Becker’s ASC Review here.

Read Does Your State Require a Certificate of Need (C.O.N)?

Read Certificate of Need Obstacles for ASCs. 

Read Certificate of Need Laws & Where They Stand