Committee advances sweeping CON reform bill; members warn of overreach and rural impacts

The Public Health committee voted to advance House Bill 5045, a broad rewrite of the state’s certificate‑of‑need (CON) regime that would relocate functions, create a three‑member oversight panel including DPH and OPM leadership, change review thresholds and expand review of transactions involving private equity, real‑estate investment trusts and other investors.

Senator Ammoir, introducing the measure, said the 49‑page bill is intended to tighten oversight of transactions that change health‑care ownership and to create a more consistent, transparent CON review. The proposal would shift the CON unit into the Department of Public Health, require quarterly meetings of the new panel, shorten the list of statutory factors for decisions, allow an expedited pathway, and raise certain daily penalties from $1,000 to $5,000.

Opponents urged more surgical fixes. Senator Gordon and others argued the bill’s expansion to small physician group transactions and the substitution of a $10 million asset/revenue threshold for an eight‑physician threshold could chill mergers that help small practices survive. “This is going after private practice groups,” Senator Gordon said, urging further amendment to protect primary‑care and rural providers.

Multiple members warned that the bill, as drafted, could allow services to leave communities without adequate process, pointing to past closures of inpatient labor‑and‑delivery care in rural areas. Sponsors said the bill is explicitly a work in progress and pledged to negotiate technical fixes with the governor’s office, the Office of Health Strategy and hospital stakeholders.

The committee recorded its roll‑call vote and advanced the bill to the floor with the understanding that substantial changes are likely during floor negotiations.

What’s next: sponsors said they will coordinate with the Office of Policy and Management, the Office of Health Strategy, hospitals and the attorney general’s office to refine thresholds and protections for small practices and rural services.