OLR Bill Analysis

HB 5048 (as amended by House "A")*

AN ACT REQUIRING CERTIFICATE OF NEED APPROVAL FOR THE TERMINATION OF INPATIENT AND OUTPATIENT SERVICES BY A HOSPITAL.

SUMMARY:

This bill requires any hospital seeking to terminate current inpatient or outpatient services to file a certificate of need (CON) application with the Office of Health Care Access (OHCA) division of the Department of Public Health (DPH).

It also requires, under certain conditions, a CON for termination of surgical services by an outpatient surgical facility, or a facility providing such services as part of the outpatient surgery department of a short-term acute care general hospital.

Generally, existing law requires CON authorization when a health care facility proposes: (1) establishing new facilities or services, (2) changing ownership, (3) purchasing or acquiring certain equipment, or (4) terminating certain services.

The bill also makes minor, conforming, and technical changes.

*House Amendment “A” adds the CON requirement for termination of surgical services by an outpatient surgical facility or a facility providing such services as part of a hospital's outpatient surgery department. It also makes minor, technical, and conforming changes.

EFFECTIVE DATE: Upon passage

CERTIFICATE OF NEED

Termination of Services By a Hospital

Under current law, a CON is not required for termination of inpatient or outpatient services offered by a hospital, but the facility proposing to terminate such services must file a modification request with the OHCA division if the proposed terminated service was originally authorized under a CON. This request must be filed at least 60 days before the proposed termination request. OHCA must hold a public hearing on the request if three or more individuals or an individual representing an entity with five or more people submits a written request for a hearing.

Under the bill, a hospital seeking to terminate any inpatient or outpatient service must file a CON application, but would not have to file the modification request.

Under existing law, unchanged by the bill, termination of inpatient and outpatient mental health and substance abuse services by a short–term acute general hospital or children's hospital does require a CON authorization.

Termination of Outpatient Surgical Services

Under current law, a CON is not required for the partial or total elimination of services provided by an outpatient surgical facility. But the requirements for termination of services cited above for hospitals involving a modification request apply.

The bill instead requires a CON for termination of surgical services by (1) an outpatient surgical facility or (2) a facility providing outpatient surgical services as part of the outpatient department of a short-term acute care hospital. But termination of such services does not require a CON under the bill if termination is due to (1) insufficient patient volume or (2) termination of any subspecialty surgical service.

BACKGROUND

Activities Requiring a CON

By law, the following activities require a CON:

1. establishment of a new health care facility;

2. a transfer of ownership of a health care facility;

3. establishment of a free-standing emergency department;

4. termination by a short-term acute care general hospital or children's hospital of inpatient and outpatient mental health and substance abuse services;

5. establishment of an outpatient surgical facility by a short-term acute care general hospital or by an entity other than a hospital;

6. termination of an emergency department by a short-term acute care general hospital;

7. establishment of cardiac services, including inpatient and outpatient cardiac catheterization, interventional cardiology, and cardiovascular surgery;

8. acquisition of computed tomography scanners, magnetic resonance imaging scanners, positron emission tomography scanners, or positron emission tomography-computed tomography scanners, by any person, physician, provider, short-term acute care general hospital or children's hospital;

9. acquisition of nonhospital based linear accelerators;

10. an increase in the licensed bed capacity of a health care facility;

11. acquisition of equipment utilizing technology that has not previously been utilized in the state; and

12. an increase of two or more operating rooms within any three-year period, starting on and after October 1, 2010, by an outpatient surgical facility or a short-term acute care general hospital.

Related Act

PA 11-10 exempts from CON review the acquisition of any equipment by a person used exclusively for scientific research on non-humans.

COMMITTEE ACTION

Public Health Committee

Joint Favorable

Yea

17

Nay

9

(03/07/2011)