The Massachusetts Public Health Council on Wednesday approved sweeping changes to the Determination of Need (DoN) process – the most wide-ranging revisions in 40-plus years to the program that reviews hospitals’ and other providers’ major capital expenditures, construction projects, and significant changes in service.
Notable provisions include:
• All new ambulatory surgical centers must either be part of a hospital or an HPC-certified accountable care organization, or if operating in the primary service area of an independent community hospital, then it must be a joint venture with, or have a letter of support from, the hospital.
• The new requirements notably allow for providers to seek a more limited review for certain projects that are deemed “conservation projects”, defined as projects that would sustain or restore a facility or service.
• Providers will now be required to submit significantly detailed information to DPH, various state agencies (as determined by DPH) for additional reviews, and undergo a public stakeholder process that may include public hearings for proposed projects. In addition, providers seeking a DoN will need to submit annual reporting to the state following the application approval.
The new rules go into effect on January 27. DoN applications submitted prior to the effective date are subject to the previous regulations.