MSDC Statement on Funding CON Legislation July 11, 2025

Dear members of the DC Council,

In the coming weeks you will have an opportunity to improve the medical community in the District. By including funding for L26-0007/B26-0005, the Certificate of Need Improvement Act, you will allow medical practices to physically remain in DC without the threat of high legal bills and disruption to care.

Since this bill was passed earlier this year, it is important to remind you what this bill contains:

• An exemption for office-based primary care, specialist practices, FQHCs, and behavioral health services.
• An exclusion from the CON process for nonpatient care capital projects (e.g, installing a new elevator in a medical building or updating an HVAC system).
• A new definition for group practice which specifies which practice types would require a CON.
• A change in the threshold for the number of beds in a medical facility, so smaller medical facilities are not treated the same as large hospitals.

Why is this legislation so important?

• The certificate of need process as a whole can take 6-9 months, creating a delay for practices to begin business changes.
• The costs of complying with a CON are in the thousands – simply completing a CON questionnaire before applying can cost thousands in legal fees to determine if the statute applies to your practice.
• Forcing practices to undergo onerous paperwork, legal, and financial exercises to make basic practice changes make it less likely physicians will keep offices in DC; physician offices moved to Maryland or Virginia deprive DC residents of healthcare choices and the District of business revenue.

The legislation has already become law, and funding this bill will begin formally implementing the much needed reforms that MSDC and the medical community have sought for years. Failure to do so will delay reforms, force medical practices to spend time and money in unnecessary paperwork, and drive more practices away from the District.

This bill is also a first step in reforming the onerous certificate of need process. This year, MSDC invites the Council to consider CON Reform 2.0, which will address further questions around in-office surgery. MSDC members have approached us that they are being sent questionnaires because of routine in-office procedures that may fall under this category – think a dermatologist removing a cancerous mole. We look forward to working with the Council on this but cannot proceed to these important changes until the Council funds the Certificate of Need Improvement Act.

Dock G. Winston, MD, MPH, MBA
President, MSDC