Certificate of Need (CON) Resource Center

December 15, 2021

Palmetto Promise Team

Breaking News Archive

State Agency to Audit South Carolina’s Certificate of Need (CON) Program
July 2021. South Carolina’s Legislative Audit Council (LAC) has voted to conduct a performance audit of South Carolina’s long-standing and anti-competitive healthcare regulations known as Certificate of Need (CON). This decision was in response to a July 16 letter signed by thirteen South Carolina Senators requesting the review.  

SC Senators Launch Effort to Repeal Competitors Veto of Healthcare Services
April 2021. It is urgent that South Carolina addresses this anti-competitive, regulatory “wall” surrounding hospitals and allows the free market to work. Time will tell if a majority of South Carolina Senators will answer the call to eliminate the competitor’s veto to healthcare. But the fight is worth having.

Neighboring States Taking Action

Florida Repeals Certificate of Need
June 2019. Florida removed the CON requirement for general hospitals, complex medical rehabilitation beds and tertiary hospital services.

Tennessee Makes Major Changes to CON Law
June 2021. The new Tennessee law, which became effective October 1, 2021, changes requirements for CON approval and streamlines the process slog.

North Carolina Certificate of Need Laws: Scandal & Corruption
March 2021. North Carolina doctors have been forced to sue over that state’s CON program. This resource covers the dark history of CON and provides a useful timeline as a primer.

South Carolina-Specific Research

 Fast Facts: SC’s Anti-Competitive Certificate of Need Laws
May 11, 2021. South Carolina’s CON program is one of the most restrictive in the United States. South Carolina requires a CON for 18 different services, including hospital renovations/new equipment that is over $600,000 and adding one or more hospital beds to a facility. Find out more top-line facts in this report.

Killer CON: How COVID and CON Conspired to Make South Carolina Sicker (forthcoming)

Can South Carolina Afford to Repeal CON?: Answers from the Data (forthcoming)

South Carolina CON State Profile
2016. Mercatus Center breaks down the ways in which CON is costing patients in access and high costs for services. 

South Carolina’s Certificate-of-Need Program: Lessons from Research
May 2021. Mercatus Senior Research Fellow Matthew Mitchell’s testimony to the SC Senate Medical Affairs Committee, including up-to-date and pertinent research from Mercatus on South Carolina’s CON program.

Former Hospital Official Addresses CON
May 2021. H. Howell Clyborne Jr., a former SC lawmaker and hospital official, writes: “There might have been a time for Certificate of Need laws. But—and I feel my background qualifies me to say this—the time has come and gone.”

South Carolina Physicians Speak Out
May 2021. A Senate Medical Affairs subcommittee heard testimony from SC doctors on S.290, the bill to completely repeal South Carolina’s Certificate of Need (CON) laws.

Presidents Obama and Trump Agree: CON Must Go

President Obama’s Federal Trade Commission and President Trump’s Department of Health & Human Services each stated that CON laws hurt patients and should be repealed.

The Case for CON Repeal in Four Minutes Flat

National Research

Conning the Competition: A Nationwide Survey of Certificate of Need Laws
August 2020. This is a still-current analysis of CON by the Institute for Justice (IJ) from a legal and policy perspective featuring a section on South Carolina.

Certificate of Need and Access to Healthcare
April 2021. This podcast features healthcare experts discussing CON laws and the dangerous restriction of care access it has caused since the outbreak of COVID-19.

How Can Certificate of Need Laws Be Reformed to Improve Access to Healthcare?
September 2021. A short book chapter on CON by two professors at Utah State University.

Permission to Care: How Certificate of Need Laws Harm Patients and Stifle Healthcare Innovation
October 2021. A policy analysis from Americans for Prosperity.

Econometric Research

Certificate-of-Need Laws and Healthcare Utilization During COVID-19 Pandemic
July 2020. A more in-depth scholarly treatment of the effects of CON from a team of economists.