Although originally created as a mandate by the Federal Government in an attempt to restrain health care cost increases, Michigan’s CON program is intended to ensure access to high quality health care services while restraining costs. In Michigan, a Certificate of Need must be granted before anyone can begin operating, expand, relocate or acquire any of the following:
- Air Ambulance (helicopter)
- Bone Marrow Transplants
- Cardiac Catheterization (Including Primary PCI and Elective PCI)
- Computed Tomography (CT)
- Heart, Lung, Liver Transplants
- Hospital Beds
- Magnetic Resonance Imaging (MRI)
- Megavoltage Radiation Therapy (MRT)
- Neonatal Intensive Care Unit (NICU)/Special Care Nursery
- Nursing Home/Hospital Long-Term Care Unit Beds
- Open Heart Surgery
- Positron Emission Tomography (PET)
- Psychiatric Beds (Acute Inpatient)
- Surgical Services
- Urinary Lithotriptors
In addition, if a licensed health care facility expends more than $3,375,000 (adjusted annually based on the CPI) on clinical space or fixed equipment, a “capital expenditure threshold” CON must be obtained even if it is not related to one of the specific covered clinical services or beds.
There are Certificate of Need review standards for each of the covered services/beds which specify the rules for qualifying for a CON. Although the State tries to maintain consistency between standards, each set is unique and requirements can vary a great deal between them. However, most of them do contain criteria for initiation, expansion, relocation, replacement, and acquisition of services.
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