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OLR Bill Analysis
HB 7050
AN ACT CONCERNING THE OFFICE OF HEALTH STRATEGY'S
RECOMMENDATIONS REGARDING THE CERTIFICATE OF NEED
PROGRAM.
SUMMARY
This bill modifies the state’s certificate of need (CON) program for
health care entities administered by the Office of Health Strategy’s
(OHS’s) Health Systems Planning Unit (HSPU). Under the program,
health care entities must generally receive CON approval when
establishing new facilities or services, changing ownership, acquiring
certain equipment, or terminating certain services.
Principally, it:
1. allows the OHS commissioner to implement policies and
procedures for the CON program while in the process of
adopting them as regulations, under certain conditions (§ 1);
2. expands the definition of “termination of services” for CON
purposes to include the termination of any services for a
combined total of more than 180 days within a consecutive two-
year period or 30 or more consecutive days (§ 2);
3. requires CON approval to acquire a proton radiotherapy
machine, unless it is a replacement for a machine previously
acquired through a CON (§ 3);
4. expressly authorizes HSPU, when reviewing CON applications
for certain hospital ownership transfers that require a cost and
market impact review (CMIR), to consider the CMIR preliminary
and final reports and other specified related materials (§ 4);
5. increases, from $200,000 to $300,000, the maximum amount
HSPU may charge an applicant for the cost of the independent 2025HB-07050-R000683-BA.DOCX
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consultant that conducts the CMIR (§ 6); and
6. allows HSPU to implement an expedited CON review process
for, among other things, applications for services, facilities, or
equipment that address an unmet need in the applicant’s
geographic area and sets related requirements (§ 5).
EFFECTIVE DATE: October 1, 2025, except that the provisions on (1)
the review of CMIR reports and an expedited CON review process take
effect July 1, 2025, and (2) the definition of “termination of services”
takes effect upon passage.
§ 1 — AUTHORITY TO IMPLEME NT POLICIES AND PROCEDURES
The bill allows the OHS commissioner to adopt policies and
procedures on the CON program while in the process of adopting them
as regulations. The commissioner may do so only if she (1) holds a
public hearing at least 30 days before implementing the policies and
procedures and (2) publishes notice of her intent to adopt regulations
on the OHS website and e-Regulations system within 20 days after
implementing the policies and procedures, which are valid until the
final regulations are adopted.
§§ 2 & 3 — TRANSACTIONS REQUIRING CON APPR OVAL
By law, health care institutions must generally receive approval from
HSPU when establishing new facilities or services, changing ownership,
acquiring certain equipment, or terminating services.
The bill adds to the types of transactions that require CON approval
acquiring a proton radiotherapy machine, unless it is replacing a
machine acquired through a CON. (This device uses high-energy proton
beams instead of x-ray beams to treat cancer.)
The bill also expands the statutory definition of “termination of
services” for purposes of the CON program. Specifically, the bill
requires CON approval when terminating a service for either (1) a
combined total of more than 180 days within a consecutive two-year
period or (2) at least 30 consecutive days. Under current law, CON
approval is needed when terminating services for more than 180 days. 2025HB-07050-R000683-BA.DOCX
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§ 5 — EXPEDITED CON REVIEW PROCESS FOR CERTAIN
APPLICATIONS
Regardless of existing CON laws, the bill allows HSPU to develop
and implement an expedited CON process for the following
applications:
1. for a service, facility, or equipment identified as having a
significant unmet need in the applicant’s geographic region in the
most recent Statewide Health Care Facilities and Services Plan;
2. acquiring a computed tomography (CT) or magnetic resonance
imaging (MRI) scanner; and
3. any other application categories HSPU designates as eligible to
request an expedited review, so long as the applicant requests it
and clearly demonstrates the proposal addresses a significant
unmet need in the applicant’s service area.
An applicant’s request for an expedited review must (1) describe the
target population the proposal will serve; (2) clearly demonstrate a
significant unmet need for the proposal in the applicant’s geographic
region based on patient demographics, diagnoses, utilization, or other
recent data; and (3) describe the availability of the proposed service,
facility, or equipment in the applicant’s primary service area.
Under the bill, HSPU must determine whether an applicant is eligible
for expedited review within 30 days after receiving a request and issue
a decision on the application within 30 days after receiving a complete
application.
The bill requires the expedited review process to allow HSPU to (1)
resolve an application by entering into an agreed settlement, approving
it (with or without conditions), or requiring the applicant to go through
the normal CON process and (2) not require a public hearing on an
application.
If HSPU requires an applicant to apply through the normal CON
process it must (1) treat the expedited review application as a properly 2025HB-07050-R000683-BA.DOCX
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filed CON application, (2) issue any request for additional information
within 30 days after notifying the applicant that they must use the
normal CON process, and (3) follow the procedures under existing law
to complete the review.
Under the bill, the expedited CON review process is not considered
a contested case under the Uniform Administrative Procedure Act
(UAPA) and HSPU’s decision on an expedited application is not
considered a final decision under the UAPA.
§§ 4 & 6 — CMIRS AND INDEPENDENT CONSULTA NT FEES
Existing law requires the state to conduct a CMIR of CON
applications that propose to transfer a hospital’s ownership if the
purchaser is (1) an in- or out-of-state hospital or a hospital system that
had net patient revenue exceeding $1.5 billion for fiscal year 2013 or (2)
organized or operated for profit. An independent consultant that OHS
retains conducts the review, at the applicant’s expense.
The bill expressly authorizes HSPU, when reviewing these CON
applications, to consider the CMIR preliminary report and the response
to it, the final report, and the parties’ written comments on the report.
It also increases, from $200,000 to $300,000, the maximum amount
HSPU may charge an applicant for the cost of the independent
consultant conducting the CMIR.
BACKGROUND
Related Bill
SB 1539 (File 431), favorably reported by the Public Health
Committee, makes various changes to the CON program, such as (1)
requiring CON approval for certain private equity acquisitions, (2)
requiring OHS to create an expedited CON review process for
applications to increase bed capacity, (3) prohibiting HSPU from
granting a request for intervenor status in public hearings involving
group practices, and (4) requiring HSPU to deny an application to
terminate a hospital’s labor and delivery services unless other services
are available within a 25 mile radius. 2025HB-07050-R000683-BA.DOCX
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COMMITTEE ACTION
Public Health Committee
Joint Favorable
Yea 21 Nay 10 (03/27/2025)