House readies renewed push on hospital regulations

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Florida has scaled back its certificate-of-need laws several times over the last two decades.

While the Republican-controlled House is taking aim again at Florida’s certificate-of-need laws, a top state official testified this week that many new hospitals are going through the existing regulatory process with little problem.

Florida is one of 35 states that have laws designed to require health care providers to justify the need for certain types of new facilities and services. Some GOP lawmakers, including House Speaker José Oliva, a Miami Lakes Republican, have argued that such regulations unnecessarily drive up the cost of health care by artificially restricting the market and maintain that the state should take more of a “free market” approach to health care.

Molly McKinstry, a deputy secretary for the Florida Agency for Health Care Administration, told House members Wednesday that in recent years most new hospitals have gone through the state’s current process without getting bogged down in regulatory fights. Those fights, which often include a hearing before an administrative law judge, can drag out for one to two years.

McKinstry said 25 acute-care hospitals received initial approvals over the past seven years. Of those 25 hospitals, 13 were approved without competitors challenging the certificates of need backed by regulators. Nine other hospitals were ultimately approved, and only three did not receive the final go-ahead.

Florida has scaled back its certificate-of-need laws several times over the last two decades. Rep. Cary Pigman, an Avon Park Republican who chairs the House Health Market Reform Subcommittee, told members of his panel that they can expect another CON rollback proposal during the 2019 session, which starts March 5.

While Oliva has sounded off on what he calls the “hospital industrial complex,” his counterpart, Senate President Bill Galvano, a Republican from Bradenton, has been more cautious, urging against complete deregulation of the health care market.

House leaders in recent years have repeatedly called for eliminating or scaling back certificate-of-need laws, which also apply to such thing as building nursing homes. The effort also had support from former Gov. Rick Scott but ran into objections in the Senate.

The issue has divided the hospital industry in the past, with some hospitals favoring changes in the CON process and others opposed. Also, the Florida Health Care Association, a major lobbying group for the nursing-home industry, has made maintaining the CON process for nursing homes a priority for the 2019 session, according to information posted on its website.

McKinstry’s hospital figures didn’t include the last round of CON preliminary approvals that were announced in December. In an unusual move, the Agency for Health Care Administration approved eight CON applications for new hospitals, The state approved two new hospitals in Miami Dade County, a 100-bed acute care facility planned by the Public Health Trust of Miami Dade — which operates the Jackson Health System — and an 80-bed facility planned by a subsidiary of its competitor, the Hospital Corporation of America.

The agency also approved competing CON applications for new hospitals in Seminole and Orange counties.

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Republished with permission of the News Service of Florida.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.



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