West Virginia Health Care Authority

Certificate of Need

Welcome to the West Virginia Certificate of Need web page. You will find background information, the latest reports and related regulatory changes. You can also place requests for reports, submit questions and provide comments and suggestions.

The Health Care Authority's goals are to control health care costs, improve the quality and efficiency of the health care system, encourage collaboration and develop a system of health care delivery which makes health services available to all residents of the State. The Certificate of Need program is a regulatory element used to achieve these goals. The program was originally enacted in 1977 and became part of the Authority in 1983. The language outlining the program is found in W.Va. Code §16-2D.

Health Care Financial Disclosure and Health Planning can also be used to draw logical implications as to how those programs work to constrain costs.

Additionally, the Authority assures public access to the information compiled under its programs, and publishes a newsletter detailing applications received and processed.

Certificate of Need (CON) programs are often associated with cost containment measures. Additionally, the Legislative findings in the CON law declare the need for health services to be provided in an orderly, economical manner that discourages unnecessary duplication.

Although some states have repealed their CON statutes, thirty-six (36) states and the District of Columbia retain some form of review. Three states limit their review to long-term care. The structure of the programs varies widely, with some states using other regulatory mechanisms instead of or in conjunction with CON programs.

In West Virginia, all health care providers, unless otherwise exempt, must obtain a CON before (1) adding or expanding health care services, (2) exceeding the capital expenditure threshold of $5,100,000, (3) obtaining major medical equipment valued at $5,100,000 or more, or (4) developing or acquiring new health care facilities.

The statutorily mandated CON review process primarily includes the determination of need, consistency with the State Health Plan, and financial feasibility. Need is determined using CON Standards, which generally include population-based quantifiable need methodologies. Financial feasibility includes the evaluation of the reasonableness of proposed charges to patients and the determination as to whether the expense and revenue projections demonstrate fiscal viability for the proposed project. Other review criteria include quality, accessibility, and continuum of care.

The advantage of CON programs to the public is that they encourage accountability by providing an avenue for public comment, discourage or limit unnecessary services, and promote community planning. In West Virginia, the CON program offers some protection for small, often financially fragile, rural hospitals and the underinsured population they serve by promoting the availability and accessibility of services and, to some extent, the financial viability of the facility....Read more 

For more information contact : Con Staff.
Glossary of CON Terms : Click here
Related Links : Click here

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