NEW: State Agency to Audit South Carolina’s Certificate of Need (CON) Program

July 28, 2021

Private: Lawson Mansell

Policy Content Manager

Sources have confirmed to PPI that South Carolina’s Legislative Audit Council (LAC), in a somewhat surprising move, 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 of CON, the aptly-named statute that allows competitors to veto efforts to provide new healthcare services in a community.

Among the signers were Senate President Harvey Peeler and Majority Leader Shane Massey. Also leading the effort were Medical Affairs Chairman Danny Verdin and Democratic Senator Richard “Dick” Harpootlian. Senator Wes Climer, a long-time champion of CON repeal who has been fighting to repeal the program in its entirety, represents the Senate on the LAC and presented the case for the audit to the Council.

This move comes after Palmetto Promise’s new report on SC’s Certificate of Need (CON) program which revealed that South Carolina has some of the most restrictive laws in the country. The PPI report also explored current applications, noting CON’s anti-competitive effect that results in barriers to entry for new healthcare providers.

According to their letter, among the specific questions the Senators wished to have addressed were:

  • The average length of the CON application process from filed application to the an approved, denied, or challenged request.
  • The effect CON laws have had on the availability and access to healthcare providers.
  • How CON laws have affected the quality of care in South Carolina.
  • A review of the “opportunity cost” associated with CONs not even filed with DHEC due to fear of litigation expenses or challenges from incumbents.
  • The frequency that denied applications were due to incumbent’s challenges.

These questions deserve complete and thorough answers.

CON laws stand in the way of patients having access to affordable, quality care. We know that. This is why we are encouraged to see that the LAC is taking this issue seriously and will be answering the questions (due in 2022) that need to be asked, mainly, how CON laws are affecting patient outcomes.

We commend the lawmakers involved in seeking LAC review for having the courage to seek factual information rather than be backed down by the leaders of the healthcare status quo.