| Credit: Photo by National Cancer Institute on Unsplash

State senators will continue discussing a proposal next week on whether to get rid of a law that requires hospitals and medical clinics to receive state permission to expand.

Supporters of a bill for which debate started Wednesday say the state’s “certificate of need” program for new medical facilities and hospital expansions is no longer needed. Two generations ago, the law was passed to help control costs and avoid duplication. But in the years since, it’s become unwieldy and has kept needed improvements from happening, they say.


Sen. Wes Climer, the York Republican who is sponsoring the bill, said the certificate of need program curbed competition. For example, he pointed to an independent oncology practice in his region that wants to purchase an MRI scanner to open a radiation treatment center, but has been thwarted.

“They were told by an area hospital CEO, ‘Don’t even try. We have the financial resources to nuke you,’” Climer said, according to The Post and Courier.

The South Carolina Hospital Association says it doesn’t support Climer’s S. 290 bill, but backs Senate Bill 370 by Sen. Scott Talley, R-Spartanburg. It is a reform measure to update the program, according to spokesman Schipp Ames.

“We hope the Senate will take swift action to reform, but not repeal the Certificate of Need program,” Ames said in a statement. “This is essential to protecting access to care for low-income families and rural communities. 

“Certificate of Need also ensures a level playing field, by keeping out-of-state providers from only offering the most profitable services without having to do their part to support South Carolina’s uninsured or underinsured patients.”

Critics of Climer’s repeal proposal say it can lead to economic conflicts and corruption.

“Do your homework,” said Fred Palm, a former executive director of the Association of Inspectors General who now lives at Edisto Beach. “This model has a long history of abuse and failure. There are different fraud schemes attached to this model. Failed health services are the most significant consequence. Corrupt investors, including physicians milking insurance payments to gin up their own income, is a primary vector of corruption and ill-service.”

Among the reforms called for by the Hospital Association are eliminating certificate of need requirements for adding beds to some existing hospitals, cutting requirements for replacement of equipment, getting rid of the need for a certificate for home health agencies and eliminating certificate requirements for eight counties that don’t have hospitals.

Debate on Climer’s bill is expected to continue Tuesday.

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