On behalf of the Virginia Spine Institute PLC, thank you for the opportunity to provide feedback to the Virginia Department of Health regarding the review of Virginia Medical Care Facilities of Public Need (COPN) Rules and Regulations.

The current COPN program is obsolete, increases the cost of care, reduces the quality of care and negatively impacts innovation.  These facts are well known by physicians and other providers, and the reason 14 states have eliminated their COPN programs.  The program has created healthcare monopolies at the expense of patients, physician practices and other small businesses.  As a result, patients have reduced access to quality care at an increased cost.  Physician practices applying for a COPN are required to spend enormous amounts of capital, over an extended period of time, with a low probability of success.  Furthermore, these regulations push patients into hospitals and other facilities when it is not necessary.  In the current world of high premiums and high deductibles, this results in another significant burden for the average consumer.

As one specific example, many procedures/services could be more efficiently and effectively performed in an office based surgical center at lower cost, with less stress on the patient all while achieving improved outcomes.  Surprisingly, the current regulatory environment is not friendly to patients and obstructs physicians ability to utilize this approach. 

It is essential that the COPN Rules and Regulations are repealed.  Creating a fair marketplace would be significant win for Virginia consumers and have no material impact on the current healthcare monopolies.  This fact can be validated by looking at many states that have already implemented successful COPN repeals. Thank you for reaching out and asking for comments. 

Sincerely,

Thomas C. Schuler, M.D., F.A.C.S.

Virginia Spine Institute CEO and Founder

Spinal Surgeon