Federal government urging Virginia to reform certificate of need laws

The Department of Justice (DOJ) and Federal Trade Commission (FTC) are urging the Commonwealth of Virginia to reform its certificate of need laws. According to the federal agencies, these laws curb competition, harm the health care market, and can ultimately hurt consumers. This stance is not surprising, as the agencies have a history of urging states to reform or repeal these laws.

Certificate of need

These laws generally require providers to gain state approval before conducting certain business activities. This includes expansion, creating new facilities, or even making some large expenditures. The FTC and DOJ believe that these laws reduce competition, as they can be used to delay or prevent new providers from entering the market.


The Virginia Certificate of Public Need (COPN) Work Group, established by the Commonwealth’s Secretary of Health and Human Resources, is investigating possible reform of the laws. The group has been tasked to evaluate specific parameters, including costs and fees associated with reviewing applications, the number of times the applications are granted or denied, the criteria for decision-making, and the relationship between this process and the provision of charity care as well as graduate medical education programs. Virginia State Delegate Kathy Byron (R-22) requested that the federal agencies weigh in on the matter.