


The Senate debate was heavily focused on many of the issues subsequently highlighted by LAC, with particular focus on the lengthy and expensive CON appeal process and the impact of CON on competition in the healthcare market. Allocating DHEC staff to annually review the agency’s tracking spreadsheet for issued CONs.īefore the LAC report was issued in February 2022, the South Carolina Senate voted 35 to 6 on Januin favor of bill S.290, which fully repealed the CON program except as to nursing homes.Suggesting the General Assembly consider restricting the use of non-compete agreements in the healthcare industry and.Suggesting the General Assembly reform CON laws to exclude low-cost facilities and equipment such as MR I and ambulatory surgery centers from CON review.Shortening the contested case process in the Administrative Law Court and requiring appeals from the ALC go directly to the S.C.Requiring greater detail from applicants on a proposed project’s impact on net patient charges and include disclosure of non-capital expenses related to a project upon its completion.Providing for further standardization of information provided in CON applications to ensure consistency in DHEC’s evaluation of applications.Adopting quantitative quality metrics in the State Health Plan.Encouraging DHEC to adequately respond to requests for CON waivers under the Governor’s COVID Executive Orders and properly track the waivers that are issued.The current thresholds were enacted in 2001 and have not accounted for inflation Increasing the dollar thresholds for equipment and capital expenditures, and providing for future indexing to inflation.Narrowing the scope of regulated services by eliminating from CON review home health agencies and narcotic and opioid treatment programs.In its report, the LAC provides specific recommendations for improvement, summarized below: Perhaps most importantly, the LAC stated: “We did not conclude from this review that the CON program should be eliminated however, our audit includes recommendations for improvement in several areas”. This article offers an overview of the LAC report and recommendations. The proposed changes appear to track closely with a number of the LAC’s recommendations and could go a long way in addressing many of the concerns held by critics of the program that underpinned the Senate’s push for repeal. Now, DHEC has proposed the first substantive amendments to Regulation 61-15 in over a decade, which have been approved by the DHEC Board and published for public comment through October 24, 2022. As we explained in an earlier post, the SC Senate passed repeal legislation that subsequently failed in the SC House of Representatives but only after an intense debate. The tailwinds surely driving these first changes to the regulations since 2012 also includes a relatively biting report issued by the Legislative Audit Council (LAC) in February 2022 (find the DHEC CON Review Report here), as well as the near repeal of the CON program.
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In some ways not surprising given the amount of attention South Carolina’s Certificate of Need (“CON”) laws received during the last session of the General Assembly, but at the same time long overdue-the state agency responsible for administering the CON laws (the South Carolina Department of Health and Environmental Control (DHEC)) is in the final stages of the regulatory process necessary to amend the CON regulations found at Regulation 61-15 of the South Carolina Code of Regulations.
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