State. Rep. Andrew Sorrell (R-Muscle Shoals) has long advocated for reforms to the Alabama Certificate of Need (CON) Review Board, which exercises the authority to accept or deny certain health care providers’ applications to offer or expand various services.
According to the National Conference of State Legislatures, CON laws are “state regulatory mechanisms for establishing or expanding health care facilities and services in a given area.”
Alabama’s CON approval process is overseen by a nine-member review board housed under the State Health Planning & Development Agency. The state legislature in 1975 established Alabama’s CON Review Board, requiring the board to consist of three consumers, three providers and three representatives of the governor.
CON laws have come under public scrutiny of late as some have claimed that such laws have proven to be ineffective in states’ efforts to combat the COVID-19 pandemic.
Leading the effort to address the issue in the state legislature is Sorrell, who, in a recent appearance on WVNN’s “The Yaffee Program,” touched on his attempt to bring about reform to the process.
“[I] like calling it a CON law because the only people they are conning are the competition,” said the North Alabama legislator. “[I]t is a barrier to free market competition in the health care system. … I’ve carried this bill for multiple years, it’s getting a lot more attention now that we’re in a coronavirus pandemic. Because now we have a shortage of hospital beds and everyone’s like we oh, the government needs to solve this problem, well maybe the government helped create this problem. Maybe we should start there.”
Sorrell spoke of the desire of Democrats to expand Medicaid, which he said would prove costly to taxpayers. Instead, the freshman legislator believes a better solution would be to reform the state’s CON laws to address the rising cost of health care, due to providers paying hefty legal fees to have their applications approved.
“A smarter play would be to abolish the Certificate of Needs Board and then these companies don’t have to spend millions of dollars getting a Certificate of Need, which of course they’re going to pass that cost along to their consumers,” said Sorrell, further stating that hospitals and rural health care providers alike must obtain a CON to provide certain services.
Sorrell outlined the possibility for corruption in the CON reviewal process, citing that board members could derail a provider’s application to eliminate competition for a company in which they hold a financial interest.
He pointed to the case of former HealthSouth CEO Richard Scrushy and former Gov. Don Siegelman (D-AL), who were indicted on corruption charges relating to Siegelman’s appointment of Scrushy to the CON Board in return for a contribution for the governor’s lottery campaign. Both individuals went on to serve time in federal prison for the infamous act.
“Richard Scrushy was the CEO of HealthSouth and he figured out that if he could get appointed to that board, he could vote no on all of his competition building a new hospital,” Sorrell added. “So, he gave $500,000 to Don Siegelman’s lottery campaign in exchange for a seat on the Certificate of Needs Board. Now, of course, both of them later ended up in jail, but we’ve done absolutely nothing to correct the problem with the Certificate of Needs Board since that happened. We’ve learned nothing from that mistake and I think that’s a real tragedy.”
Sorrell went on to outline his previous efforts to abolish the state’s CON Board. The Shoals-area state representative stated his intentions take a slightly different legislative approach in the future, aiming to reform certain aspects of the process in order to gauge interest in launching a debate on the board as a whole.
Dylan Smith is a staff writer for Yellowhammer News. You can follow him on Twitter @DylanSmithAL
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