SC high court to hear Certificate of Need case

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COLUMBIA — South Car­olina’s highest court is gearing up for a debate over whether the state health agency can end a program that regulates the building or expansion of medical facilities.

On Thursday, the state Supreme Court will hear arguments over the Certificate of Need program, an approvals process administered by the Department of Health and En­vironmental Control and required under state law for any medical facilities seeking to build or expand.

The program has been on hold since June, when Gov. Nikki Haley vetoed the $1.7 million needed to run it, saying she thinks it’s an impediment to the free market and isn’t needed. The House sustained Haley’s veto after Ways and Means Chairman Brian White took the floor and said the veto was just about the money, not whether the program should continue.

Since that vote, some House Republicans have said they didn’t intend to nix the program entirely, pointing out last summer that an executive decision to discontinue the program “may be contrary to law but is certainly contrary to the will and intent of the House of Rep­resentatives.”

State law still requires medical facilities to acquire a Certificate of Need from DHEC before building, expanding, offering a new service or buying medical equipment costing more than $600,000.

When Haley vetoed the funding, about three dozen projects worth about $100 million were being reviewed by DHEC.

Groups including the South Carolina Hospital Asso­­ciation sued over the issue, saying the state law requiring the review is still on the books and can’t be suspended just because DHEC didn’t set aside money to pay for it. Supporters also have argued that the Certificate of Need program is needed to keep costly medical services or hospital beds from going unused and that it ensures rural communities keep access to health care.

“That the CON Act has not been repealed demonstrates the General Assembly’s intent that it should remain the law of this state,” the hospitals said in their lawsuit.

DHEC asked the Supreme Court to decide whether the agency could suspend the program. A Senate resolution to compel DHEC to otherwise fund the program is pending in a medical affairs committee.

Haley said her veto meant the program is finished, and that companies shouldn’t have to get approval before they make business decisions.
“The court should disregard the rhetoric that has surrounded this case and apply the law as it has always been understood: When the General Assembly does not allocate funding to an agency to perform a specific statutory task, that statutory responsibility is suspended for the upcoming fiscal year,” Haley’s attorneys wrote in an amicus brief.

Haley has long opposed the Certificate of Need program. Before she became governor, she worked as a fundraiser for Lexington Me­di­cal Center, which spent nearly a decade fighting with DHEC over whether it could do open-heart surgery before reaching a compromise with another area hospital.


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