South Carolina Senate votes to end certificate of need program

South Carolina canceled its Certificate of Need program after state senators overwhelmingly voted Tuesday to eliminate the requirement.

A 35–6 vote sends the bill to the House of Representatives.

The issue was not on the radar of many observers when the session began, but the Senate acted swiftly on its part, fending off any attempts by supporters to keep parts of the program, such as the South Carolina Hospital Association, who say it protects healthcare. in rural areas and can prevent hospital overruns due to competition.

The most vocal repealists came from high-growth areas such as Horry County and the suburbs south of Charlotte, North Carolina. The groups there were unable to convince state regulators and the courts that the hospital was needed to serve the area.

“Eighteen years without a hospital. Eighteen years without medical attention. Broken bones, ruptured spleens, heart attacks, childbirth, it all came and went,” said state senator Michael Johnson, a Fort Mill Republican.

The Certificate of Necessity Act requires permission from the State Department of Health and Environment to build or expand hospitals or purchase expensive equipment such as MRI machines. Supporters, including hospital systems across the state, said the rules save money by avoiding costly duplication of services, encourage the placement or stay of medical care in rural areas, and ensure that the care offered is of the highest quality. Fifteen states canceled their programs that had been sanctioned by the federal government in the 1970s.

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The six senators who voted against the repeal said they were concerned that already dire rural healthcare options would get worse.

“Hopefully I’m wrong about where this cancellation will lead,” said Sen. Kevin Johnson, D-Manning, who said his local hospital, McLeod Health Clarendon, asked him to vote no for fear that excess competition would lead to a win. the hospital will go bankrupt, and these competitors will leave the rural areas themselves.

But the bill has received some support from Democrats. “It’s impossible for things to get worse when you don’t have hospitals,” said Sen. Mike Fanning, representing rural counties Fairfield and Chester.

The bill’s main sponsor, Senator Wes Clymer, R-Rock Hill, said the merger of hospital systems across South Carolina and the COVID-19 pandemic have made a difference in repealing the law.

In the past, every healthcare facility had to hire a consultant to help get through the process of getting the certification of necessity, plus a lawyer to read the documents, and if they won the certification, even more lawyers to deal with the inevitable decision appeal, Clymer. said.

“All you have to do now is raise money and go build,” he said.

If the repeal becomes law, the 28 projects worth over $1 billion currently tied up after initial approval could be built for free. These range from a 98-bed hospital in booming Lancaster County to nine new cradles in a neonatal intensive care unit in Charleston, according to information Clymer provided to the senators.

Thirty-four projects pending approval no longer need it, including 10 different businesses that want to be able to spend $70,000 each to give intravenous drugs to people in their homes in the state’s most rural counties.

“There is a widespread desire for competition in medicine,” Climer said.

The certificate of need almost died in 2013 when the then governor. Nikki Haley vetoed $2 million from the state budget, which officials used to launch the program. The hospitals sued, saying lawmakers never voted to end the program, and in 2014 the state Supreme Court ruled that it should continue.

The House of Representatives has passed bills to curtail the program before, but none of them has stopped it completely.

Democrat Kevin Johnson said he would like some Republicans so passionate about ending the Certificate of Need to join them on another health care proposal.