On behalf of the Medical Society of Virginia (MSV), thank you for the opportunity to provide feedback to the Virginia Department of Health regarding the periodic review of Virginia Medical Care Facilities Certificate of Public Need (COPN) Rules and Regulations [12VAC5-220].

The current COPN program in Virginia is outdated; it was adopted in 1973, in part because of a federal requirement. The requirement was later repealed due its inability to control cost, regulate quality, or increase access to care. Fourteen states have discontinued their COPN programs because the they have been proven ineffectual at the program’s original aim.

These fundamental flaws are still prevalent as we assess the outcomes of Virginia’s current COPN program. The Federal Trade Commission has noted COPN can limit consumer choice and stifle innovation, while our own All Payer Claims Database (APCD) shows that most services are cheaper in non-hospital outpatient settings (MRI $1797 hospital; $406 doctor’s office) and nationally, studies have shown that hospitals in states with COPN have higher costs than those without COPN. Finally, numerous studies have shown that COPN is irrelevant when it comes to quality; for example, Minnesota doesn’t have COPN and is ranked in the top 10 for quality in the country, whereas Virginia is in the middle 30.

MSV believes Virginians deserve access to modern high-quality healthcare. As such, MSV supports the deregulation of COPN, while maintaining regulatory oversight to ensure newly deregulated services maintain patient safety and quality standards, accreditation, and strong enforceable charity care. MSV welcomes the opportunity to work with the Administration to develop a modern program that meets the needs of patients and providers in the Commonwealth.

Thank you for the opportunity to provide comment.