Lawmakers hear competing evidence and local testimony on West Virginia’s certificate-of-need rules

At a joint meeting of the Legislature’s Joint Committee on Health, state officials, hospital executives, economists and policy advocates presented competing views on West Virginia’s certificate-of-need (CON) regulatory program and its effects on access, cost and quality of health care.

Justin Cox, executive director of the West Virginia Health Care Authority, gave an overview of the agency’s responsibilities and operations. The authority administers the CON program and a financial-disclosure unit under West Virginia Code §§16‑2D and 16‑2‑9B. Cox told the committee the office processed three main types of requests in 2024: 36 requests for determinations of reviewability (all but two were found not reviewable), 35 full CON applications (either approved or pending) and 239 exemption requests (all completed and approved). He described the agency’s batching and review timeline: applications are batched twice monthly (the 15th and 30th), a 30‑day notice period for affected parties follows the batch date, and the board decision is due by the sixtieth day of the review cycle — about 70 days from a letter of intent in uncontested cases. Cox said exemption requests are typically handled on a 14‑day goal and confirmed a fee schedule exists for applications, which ranges from roughly $1,500 to $35,000 depending on total capital expenditures.

Hospital leaders urged caution about…