The governor is expected to consider a bill to help medical facilities make capital improvements more easily and to require the University of Mississippi Medical Center to seek state approval before opening clinical facilities outside its Jackson campus.
The legislation unanimously passed the Senate Wednesday.
Lawmakers passed nearly identical changes to the state’s certificate of need law last session, but this year, they removed a provision that led Republican Gov. Tate Reeves to veto the legislation in April. The House unanimously passed the bill Jan. 21.
Certificate of need law requires providers who want to open new services or make costly expansions – above a certain dollar threshold – first prove they are needed in their area. The process aims to lower costs and improve the quality and accessibility of health care by preventing duplication of services, but stakeholders are divided on whether or not the law accomplishes its goals.
The bill that passed Wednesday would increase the cost threshold that triggers the requirement. It also seeks to level the playing field between the University of Mississippi Medical Center and other health care providers by limiting UMMC’s certificate of need exemption to the area around UMMC’s main campus and the Jackson Medical Mall. For years, UMMC has been exempt from certificate of need requirements for facilities or equipment that is used for educational purposes.
Chairmen of the House and Senate’s public health committees have said hurrying this bill through the legislative process will allow lawmakers to propose additional changes this session to the existing law, which requires medical facilities to apply for a certificate of need, often called a CON, from the Mississippi State Department of Health before opening or adding new services.
“It’s my intention to have one, if not two, additional certificate of need bills during this session, in particular something dealing with rural hospitals,” said Public Health and Welfare Chairman Hob Bryan, a Democrat from Amory, during his committee’s meeting Jan. 21.
On Wednesday, the House Public Health and Human Services committee passed a separate bill to exempt existing rural hospitals altogether from requiring state approval to open new health services or make improvements within a five-mile radius of the home hospital.
Rep. Sam Creekmore, R-New Albany, discusses his disappointment that the state Senate conferees did not attend a meeting to discuss their updated legislative plans for the cost of Mississippi Medicaid expansion during a public legislative conference committee meeting at the Mississippi State Capitol on Thursday, April 25, 2024. Credit: Eric Shelton/Mississippi TodayThe bill, authored by committee Chairman Sam Creekmore, defines rural hospitals as critical access hospitals, those located in Delta counties or in counties with a population under 15,000 people.
“This would allow our rural hospitals to add whatever service they want without having to go through the CON process, hopefully making them more profitable, and providing better health care services at the same time,” said Creekmore, a Republican from New Albany.
Legislators noted that some rural counties, like Humphreys, do not currently have a hospital, meaning residents would not benefit from the proposal.
The bill will now go to the House State Affairs committee for review.
The State Board of Health subcommittee tasked with exploring changes to certificate of need laws has recommended excusing small rural hospitals with existing certificates from seeking approval before adding services or making capital expenditures that exceed statutory limits. It also recommended exempting substance use treatment and psychiatric services from acquiring a certificate of need from the state before opening.
In Mississippi, where more than half of rural hospitals are at risk of closure, some people argue the legislation harms rural hospitals by restricting the services they are allowed to offer.
If the governor signs the bill that cleared the legislature Wednesday, it will become law immediately.
The legislation directs the health department to study easing some approval requirements for small hospitals for dialysis and geriatric psychiatry services. The bill also requires the agency to study requiring psychiatric facilities to treat a certain percentage of uninsured patients, and approves or revises certificates of need for specific facilities in Madison, DeSoto and Harrison counties.
It did not include a provision to grant a new certificate of need to Oceans Behavioral Hospital Jackson. The language, which was added during last year’s session as an amendment by Bryan, would have ended a legal dispute between Oceans and another local hospital over the amount of free or low-cost care Oceans must provide to patients in need. The addendum led Reeves to veto lawmakers’ CON bill.
“The proposed amendment smacks of both imprudent legislative favoritism towards the entity that will receive the CON, as well as bald prejudice to the other market participants,” Reeves wrote in his veto message. “In either case, awarding a CON by legislative fiat is bad public policy.”
The state’s certificate of need law is a familiar target for legislative reform in Mississippi, but few substantial changes have been made to the law since 2016.
Critics argue the law stifles competition and fails to decrease costs. Advocates say it ensures that communities have access to a range of health services, not only those that are profitable.
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