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Audit recommends lawmakers make significant changes to Health Care Authority

CHARLESTON, W.Va. — A legislative audit reported to leading state lawmakers Tuesday concludes a key duty of the state Health Care Authority, the Certificate of Need process, is ineffective and an unnecessary barrier to health care in the Mountain State.

The audit report was made a day before lawmakers go into session where they will likely be considering hundreds of millions of dollars in budget cuts.

The report concluded:

“The Legislative Auditor’s Office could not prove that Health Care Authority’s Certificate of Need Program lowers health care costs in West Virginia. Thus, we recommend that the requirement that health care facilities must obtain a Certificate of Need from the Health Care Authority be eliminated.”

MORE Read audit report here

Hospitals and other health care facilities are required to seek a CON when they plan new construction or new programs, like open heart procedures, at their facilities. One of the main goals of the process is to hold health care costs down but the audit concluded per capita health care costs have grown in West Virginia in recent years. The audit also said very few CONs are denied.

Health Care Authority member, former chairwoman, Sonia Chambers argued in favor of the process after the audit report was given Tuesday at the capitol.

“Almost all of the hospitals in West Virginia would tell you that it is a very important thing to have,” Chambers told MetroNews after the meeting. “They are the people out on the front lines treating people 24/7.”

Chambers said the CON process helps guarantee quality of care.

“I think it’s really important for policymakers, like legislators, to have some good, solid, information about the financial health of those facilities (hospitals)–how those services are being delivered,” she said.

The audit also recommended restructuring the Health Care Authority. Just last year lawmakers repealed the agency’s rate review authority.

After hearing the report, House Finance Committee Chairman Eric Nelson (R-Kanawha) said the program should be reviewed.

“There’s some facts that are present that truly question if we need to continue with our CONs,” Nelson said.

The CON process was updated in legislation passed by lawmakers last year. Chambers said those changes should be allowed to mature.

“We ought to allow that a little bit of time to play out,” Chambers said.

The Health Care Authority, which used to be called Health Care Cost Review Authority, was created in 1983. It receives $5 million annually in special revenue funds from the state budget.

Chambers agreed the state is in tough financial times. She said the HCA supports the review of spending.

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