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The Mississippi House of Representatives passed a bill Wednesday that would make it easier to open or add certain health care services in the state. 

The proposed legislation would free substance use treatment, outpatient hospital dialysis, intermediate care facilities, psychiatric residential treatment facilities for youth, birthing centers and diagnostic imaging services from being required to acquire a “certificate of need” from the state to open. 

The bill also would double capital expenditure limits, or the maximum amount hospitals can spend on renovations or equipment without approval, streamline the certificate of need application process and require the Mississippi Department of Health to publish a State Health Plan annually using the most recent available data. 

The legislation is intended to make health care more affordable and accessible in rural parts of the state, said Rep. Hank Zuber, a Republican from Ocean Springs and author of the bill.

“Hopefully it’s just the beginning,” Zuber said. “We’re going to try to do everything we can to make sure the rural part of the state has affordable and accessible medical care.” 

The bill, co-authored by Rep. Sam Creekmore, the chair of the Public Health and Human Services committee, passed the chamber with a vote of 107-5. It now heads to the Senate. 

The federal government mandated states to implement certificate of need laws in 1974, but repealed the mandate a decade later. The laws seek to reduce health care costs and increase the accessibility and quality of health care services by safeguarding against duplicate services. 

Critics argue that the laws stifle competition and fail to reduce costs. Advocates say they ensure that communities have access to a wide range of health services, not just profitable ones. 

Zuber’s legislation strikes a balance between these viewpoints: it makes it easier to open needed services, but does not do away with certificate of need laws entirely. 

Creekmore said the bill removes services that no longer benefit from the certificate of need program. 

“CON has matured over the years and there are some facilities and services that have aged out of certificate of need,” he said. 

The services he believes have aged out of the law include those that are in-demand and those that already exist but are limited by certificate of need regulations. 

Under the new law, hospitals will be able to use existing dialysis facilities for outpatient renal care, allowing patients to remain in their communities while undergoing treatment rather than traveling long distances for care. The new regulations for dialysis, if passed, will take effect in four years. 

Most rural counties in the United States do not have a dialysis facility.

Creekmore said waitlists in Mississippi for psychiatric residential treatment facilities for youth top 40 patients, evidencing a need for the services. The Department of Health requested that the facilities be removed from certificate of need regulations, and the Department of Mental Health helped to draft the bill’s language, Creekmore said. 

A U.S. Senate report published last July called the facilities “warehouses of neglect” and argued that children routinely suffer harm in such facilities while operators profit from taxpayer funding. Several of the companies studied in the report, including Universal Health Services and Acadia Healthcare, operate facilities in Mississippi. 

Acadia Healthcare’s political action committee made a donation to Rep. Creekmore’s last September, even though it was not an election year, according to campaign finance reports available publicly on the Secretary of State’s website. 

A bill sponsored by Rep. Lee Yancey, R-Brandon, to remove psychiatric residential treatment facilities and substance abuse treatment from certificate of need requirements passed the House of Representatives last year but died in conference.  

Certificate of need applications are often contested by competing health care facilities, and it can take months or years to be approved to provide a new service or open a new health care facility. The appeals process can be expensive and can stifle needed services, especially in rural areas, according to health officials.

The new bill will expedite the application process by ordering the Mississippi Supreme Court to appoint a special chancery judge to hear appeals and return a final decision within 120 days of appointment. 

Rep. Omeria Scott, D-Laurel, expressed concern that the legislation will make changes to the state’s certificate of need program before the Mississippi Department of Health has the opportunity to publish an updated State Health Plan.

Scott argued that loosening provisions in the certificate of need law would be costly for the state’s Medicaid program. “This is a budget buster,” she said. 

Creekmore said the bill would not have any fiscal impact on the state budget. “I can assure you, this CON bill won’t cost the state a dime,” said Creekmore.