Committee approves CON reform substitute after debate over hearing and appeal rights

Representative Maryanne Proctor introduced a committee substitute to House Bill 407 designed to streamline Kentucky's Certificate of Need (CON) process while leaving CON law in place. "What this bill seeks to do is streamline the process of CON. That's all it does. It does not repeal Certificate of Need," Proctor told the committee.

Colleen Lingren of the Pacific Legal Foundation framed the reform as consistent with a broader national trend to modernize CON, noting some states have narrowed or repealed CON and arguing the substitute helps remove procedural obstacles to new providers. "There are dozens of studies...the evidence is overwhelming that reducing or streamlining certificate of need laws overwhelmingly reduces cost to the consumer and increases access," Lingren said during testimony.

Mark Gilfoil, testifying for St. Elizabeth Healthcare, opposed the committee substitute and urged caution. He told members the sub would, in his reading, transfer exclusive procedural control to applicants by removing an "affected person's" ability to request a public hearing, limiting who may present evidence at hearings, and constraining court appeals. "This bill will do damage to the certificate of need process," Gilfoil said, arguing the changes could harm safety-net hospitals that serve large numbers of low-income and publicly insured patients.

Sponsors responded that the committee substitute requires the Cabinet to establish a process to solicit information from incumbent providers and that the language aimed to prevent procedural tactics that have been used to delay or derail applications. Committee members pressed both sides on whether the substitute removes meaningful rights to appeal; some members asked to revisit appeal language in later discussions.

Despite explained 'no' votes and members' requests for future refinement on appeals and stakeholder protections, the committee adopted the substitute and passed HB 407 with favorable expression.