Office of Health Strategy outlines CON changes, seeks clearer rules and expedited reviews

HARTFORD — The Office of Health Strategy (OHS) asked the Public Health Committee on March 24 to approve a series of changes to Connecticut’s certificate-of-need (CON) law aimed at giving the agency clearer tools and a faster path for certain reviews.

Commissioner Deidre Gifford, testifying for OHS, described a package she said would improve transparency and efficiency. “First of all, it would allow OHS to establish policies and procedures as a prelude to, regulation for the certificate of need statute,” Gifford told the committee. She also proposed tightening the statute’s definition of “termination of services” and adding an expedited CON review route when the agency or an applicant identifies a “significant unmet need.”

Nut graf: The testimony highlighted longstanding concerns about lengthy CON timelines and inconsistent outcomes. Gifford said the median time from filing to final action has fallen since she took office, but that clarifying what OHS may rely on — for example cost-and-market-impact reviews — is needed to avoid ambiguity and allow the agency to use all the evidence it commissions.

Gifford told lawmakers OHS would clarify that a termination of services occurs after either “180 days of closure of the service in a 2 year period or any 30 day consecutive closure,” language the agency says is designed to prevent facilities from cycling services on and off to avoid review. She also explained why the agency wants proton-beam therapy added to the list of services that require CON, and recommended an expedited 30-day review for narrowly defined cases.

“We propose adding cost and park market impact review, making it clear that the agency can actually consider the findings in a cost and market impact review when they’re, when 1 is required for the transfer of ownership of a hospital,” Gifford said, describing statutory ambiguity that can prevent one unit within OHS from using the work of another.

Lawmakers pressed Gifford on timelines and public transparency. Senator Amore and Representative McCarthy Vehi asked whether a forthcoming modernized portal will show whether delays were driven by applicants or by OHS. Gifford said OHS has begun publishing an “active dockets” page that flags when the agency awaits information from an applicant, when an agreed settlement is being negotiated and when a docket is pending other agency action.

Republican and Democratic lawmakers also pushed on private-equity oversight and transactions involving notice-of-material-change procedures. Gifford said OHS supports additional transparency around private-equity deals and described coordination with the attorney general’s office for antitrust review.

Several witnesses from hospitals and provider groups urged caution about wholesale reductions in CON or removing CON review for some service changes. The Connecticut Hospital Association told the committee that any expedited process should include a right for an affected stakeholder to request a hearing. Hospitals also opposed removing commercial reimbursement for off-campus infusion and injection services, saying that would risk closing sites patients use now.

What’s next: The committee will continue to consider language. Members signaled interest in targeted reforms — such as stricter timelines, limited expedited paths for specific services, and clearer statutory authority for OHS to use internal reports — while preserving procedural protections for affected stakeholders.

Ending: Lawmakers and witnesses agreed on the political difficulty of the topic. Several said they were willing to negotiate narrower, statutory changes that would reduce delay without sweeping overhaul. OHS said it is open to continuing work with the committee to refine statutory language and to coordinate better with the attorney general’s office on concurrent reviews.