Certificate-of-need laws vary by state, and they can have pros and cons for healthcare providers seeking to open new practices in the orthopedic space and beyond.
The laws aim to control healthcare costs by restricting the duplication of services in an area, but some systems and physicians say the laws restrict healthcare development and growth as demand grows in certain areas.
Here are where certificate-of-need laws exist, and do not exist, according to 2024 data from the national Conference of State Legislatures:
No certificate-of-need laws
California
Colorado
Idaho
Kansas
New Hampshire
New Mexico
North Dakota
Pennsylvania
South Dakota
Texas
Utah
Wyoming
Certificate-of-need laws in place
Alabama
Alaska
Arkansas
Connecticut
Delaware
Florida
Georgia
Hawaii
Illinois
Indiana
Iowa
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Mississippi
Missouri
Montana
Nebraska
New Jersey
New York
Nevada
North Carolina
Ohio
Oklahoma
Oregon
Rhode Island
South Carolina
Tennessee
Vermont
Virginia
Washington
West Virginia
Wisconsin
Certificate-of-need law variations
Arizona: Although Arizona does not have certificate-of-need laws, the state requires an application for ambulance services and ambulances to be filed with the Department of Health Services and the Bureau of Emergency Medical Services & Trauma System.
Minnesota: Minnesota does not have certificate-of-need laws, but the state maintains moratoriums and processes for exceptions to moratorium for several health facilities.
Wisconsin: Wisconsin does not have certificate-of-need laws, but it requires certain approvals for long-term care, and moratoriums for hospital, psychiatric and chemical dependency and nursing home beds.