HB 432 -- CERTIFICATE OF NEED

SPONSOR:  Wright

COMMITTEE ACTION:  Voted "do pass" by the Committee on Health
Care Policy by a vote of 8 to 6.

This bill limits the application of the Certificate of Need Law
to long-term care facilities.  Currently, it covers health care
facilities.  The change is effective January 1, 2004.

FISCAL NOTE:  Estimated Net Cost to General Revenue of $126,000
in FY 2004, FY 2005, and FY 2006.

PROPONENTS:  Supporters say that in 1974, the federal government
mandated the establishment of certificate of need laws in an
effort to control health care expenditures and to ensure that
health care resources were used efficiently and distributed
fairly.  The effects of the Missouri law have been increased
capital expenditure costs, limited competition, and the re-
location of health care providers to other non-certificate of
need states.  The certificate of need process is very time
consuming and results in numerous compliance standards, costly
litigation, and limited patient choice.  In order to increase
patient choice and to prevent additional health care providers
from leaving Missouri, the law as it applies to health care
facilities should be repealed.

Testifying for the bill were Representative Wright; Philip M.
Willcoxon, Chief Executive Officer, Freeman Neosho Hospital;
Robert J. Cimasi, President, Health Capital Consultants; Nancy
Seelen, Vice President, Public Affairs, St. Luke's Health System
of Kansas City; John Hennessy, Executive Director, Kansas City
Cancer Centers; Paul Kerens, Senior Executive Officer, Kansas
City Orthopedic Institute; Jeffery W. Bush, President, Popular
Bluff Medical Partners; St. John's Regional Medical Center of
Joplin, Missouri; and Missouri State Medical Association.

OPPONENTS:  Those who oppose the bill say that since the
operation of the health care market is based on the dissemination
of incomplete information and data, some form of government
oversight is needed.  If the law is revised or repealed, cost
control mechanisms and quality of care requirements would be
affected, resulting in increased health care costs, decreased
quality of care for patients, and increased duplication of
services.  Integrity is maintained throughout the certificate of
need process and members of the review committee carefully review
application documents.  If the law is revised or repealed, the
public welfare of Missouri citizens could be affected and the
erosion of wages for health care workers in Missouri could occur.

Testifying against the bill were Missouri Hospital Association;
BJC Health Care; St. Louis Area Business and Health Coalition;
Associated Industries of Missouri; Carondelet Health Systems of
Kansas City; Missouri Health Care Facilities Review Committee;
and Health Midwest.

Joseph Deering, Legislative Analyst

Missouri House of Representatives
Last Updated July 25, 2003 at 10:11 am