Minnesota strictly limits healthcare growth through the use of moratoria. Minnesota’s moratoria apply within two broad categories—hospital beds and facilities/building. Minnesota does not have a traditional CON program. Instead, it allows narrow exceptions to its existing moratoria through a “public interest review” (PIR) program. See Minn. Stat. § 144.552. For this reason, some have deemed Minnesota a “quasi-CON” state. To initiate the PIR process, an applicant must submit a plan illustrating, among other things, that a need exists for a prohibited facility. See Minn. Stat. § 144.552. PIR applicants must include their competitors’ positions with their initial application. Minn. Stat. § 144.552(f). The Department of Health reviews those applications and may make changes before recommending action by the full Minnesota Legislature. See sidebar on p.87.
As of May 15, 2020, Minnesota had not suspended any PIR requirements in response to COVID-19.
In Minnesota, anyone interested in obtaining a license to operate a new hospital or expand beds in an existing hospital must submit a plan to obtain an exception to the state’s moratorium. Minn. Stat. § 144.552. The plan must address: (1) whether a new hospital or new beds are necessary to provide access to care or improve services; (2) the financial impact of a new hospital or new beds; (3) how existing hospitals would be affected; (4) whether proposed services would be available to nonpaying or low-income patients; and (5) the views of affected parties. Minn. Stat. § 144.552(c)(1)-(5). The PIR process takes up to 150 days, during which time the Department takes an active role in suggesting adjustments to the plan. The Department then makes a recommendation to the Minnesota Legislature. That recommendation can be different than what the original applicant asked for. Minn. Stat. § 144.552(c). Applications can be submitted at any time and there is no application fee. A public hearing is required before an application is approved or rejected, and competitors can offer evidence and testimony as to why the PIR application should be rejected. Minn. Stat. § 144.552(f).
|CON?||Number of PIRs||Moratoria||Temporary COVID-19 response:|
|Hospital Beds||Yes||-||1||No action|
|Beds Outside Hospitals||No||-||-||-|
|Facilities/ Buildings||Yes||-||2||No action|
|Emergency Medical Transport||No||-||-||-|