Virginia s COPN Program

Transcription

1 Virginia s COPN Program Presented by Matthew M. Cobb Date June 3, 2015 Williams Mullen 200 South 10 th Street Richmond, Virginia Tel: mcobb@williamsmullen.com

2 COPN Program Background Established in All states required to have COPN programs under the National Health Planning and Resource Development Act of Federal requirement for states to have COPN was repealed on January 1,

3 COPN Program objectives COPN laws were enacted across the country with the stated purpose to address issues including: Cost containment Indigent care Access to care Consumer involvement Distribution of services Education of public in use of the health care system 3

4 4 COPN Program Objectives 12 VAC outlines the guiding principles for the COPN program: 1. The COPN program is based on the understanding that excess capacity or underutilization of medical facilities are detrimental to both cost effectiveness and quality of medical services in Virginia. 2. The COPN program seeks the geographical distribution of medical facilities and to promote the availability and accessibility of proven technologies. 3. The COPN program seeks to promote the development and maintenance of services and access to those services by every person who needs them without respect to their ability to pay.

5 COPN Program Objectives 4. The COPN program seeks to encourage the conversion of facilities to new and efficient uses and the reallocation of resources to meet evolving community needs. 5. The COPN program discourages the proliferation of services that would undermine the ability of essential community providers to maintain their financial viability. 5

6 COPN Program Objections Those opposed to COPN programs often argue: COPN programs do not actually control health care costs. Creates barriers to entry into the market. Limits competition. Open market v. regulated market discussion. 6

7 COPN Process Batch Cycles File a Letter of Intent File a COPN application Respond to Completeness Questions Public Hearing Health Systems Agency Review DCOPN Staff Review Recommendations from DCOPN and Health Systems Agency IFFC Recommendation and Decision Appeals 7

8 COPN Reforms/Challenges Efforts to repeal or reform the COPN program in Virginia: 1989 legislation to significantly deregulate COPN, but was never fully implemented and repealed in efforts removed a moratorium on new nursing home beds and established the Request for Applications process legislation was enacted requiring a transition for the elimination of the COPN requirements based on recommendations of the Joint Commission on Health Care and agreed to by the COPN community. Required funding for the transition never materialized. 8

9 COPN Reforms/Challenges 2009 Revisions to the COPN law consolidated and revised the process and review criteria. Other reforms over the years. Colon Health Centers of America, LLC. v. Hazel: Pending litigation raising a constitutional challenge to Virginia s COPN program. Argue Virginia s COPN program violates the dormant commerce clause and three provisions of the Fourteenth Amendment. 9

10 General Assembly Action House Bill 2177 (Del. Orrock) & Senate Bill 1283 (Martin) Revised capital expenditure rules. Directed the Secretary of Health & Human Resources to convene a workgroup to review the COPN process and impact on health care services in Virginia and the need for changes to the COPN process. The workgroup has been tasked with evaluating: > the process by which applications for certificates of public need are reviewed, the criteria upon which decisions about issuance of certificates of public need are based, and barriers to issuance of a certificate of public need.

11 2015 General Assembly Action > the frequency with which applications for a certificate are approved or denied; > fees charged for review of applications for a certificate of public need and the cost to the Commonwealth of processing applications for a certificate of public need; > applications for and the impact of the current certificate of public need process on establishment of new health care services, including the establishment of new intermediate-level or 3 of 3 specialty-level neonatal special care services and open heart surgery services and the addition of new beds or operating rooms at existing medical care facilities; 11

12 2015 General Assembly Action > the relationship between the certificate of public need process and the provision of charity care in the Commonwealth and the impact of the certificate of public need process on the provision of charity care in the Commonwealth; > the impact of the certificate of public need process on graduate medical education programs and teaching hospitals in the Commonwealth; > the efficacy of regional health planning agencies, the role of regional health planning agencies in the certificate of public need process, and barriers to the continued role of regional health planning agencies in the certificate of public need process; and 12

13 2015 General Assembly Action > the frequency with which the State Medical Facilities Plan is updated and whether such plan should be updated more frequently. 13

14 What does this mean for the Future? Ongoing debate over the value of Virginia s COPN program. The Secretary s COPN Workgroup will get a lot of attention leading into next year s General Assembly session. 14

15 Conclusion Questions? 15