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Home / Advocacy / Issues / Certificate of Public Need (COPN)

Virginia’s Certificate of Public Need (COPN), sometimes referred to as CON (Certificate of Need), program was created in 1973 by a federal mandate. The mandate requires health care providers seeking to open or expand a health care facility to receive approval from a regulatory body to prove that a community needs the services the facility would deliver. Its original purpose was to control cost and increase access to care, but it has failed to do either. The federal mandate was repealed in 1986, but Virginia’s program remains.

In the years since, Virginia’s COPN has failed to improve access, control costs, and ensure quality.

  • COPN restricts access for Virginia’s most vulnerable patients.
  • There is no evidence that states with COPN provide more charity care. 
  • Virginia Health Information shows that most services are cheaper in physician offices, and yet COPN restricts more services and facilities from being offered to underserved communities.

COPN creates higher out of pockets costs for patients and care is delayed because they can’t shop for lower priced services.

COPN laws prevent private health care providers from competing with larger providers to bring patients the same service at a lower cost in a more convenient location.

MSV participated in the 2019 multi-stakeholder COPN workgroup, convened by the Secretary of Health and Human Resources, Daniel Carey, MD.

MSV’s Position on COPN

MSV supports modernizing Virginia’s COPN. Any changes must ensure patient safety and access to quality, affordable health care, as well as include charity care requirements.

MSV Supports

  • Legislation that modernizes COPN regulations and meets the criteria specified for patient safety, accreditation, quality, and charity care.  
  • Reforming charity care to increase the number of charity care providers and increase access to care. Reforms must also contain enforceable standards for charity care. 

COPN Resources

Virginia policy puts special interest above patients - Washington Post

VDH Certificate of Public Need Program

Take Action

If you are interested in learning more about MSV's work on COPN contact the MSV Government Affairs team.