Alaska

Alaska

Alaska requires CONs within five broad categories—hospital beds, beds outside hospitals, equipment, facilities and services. Alaska is the only state that maintains a standard minimum expenditure of $1.5 million across all of its CONs, except its equipment CONs, meaning none of its other CON requirements are triggered until: (1) an individual or facility propose a project or service covered by a CON and (2) the project or service will cost more than $1.5 million. Alaska Stat. § 18.07.031(a), (d). CON application fees in Alaska can cost as much as $75,000.

COVID-19 Response

On April 14, 2020, Governor Dunleavy issued an order allowing hospitals to temporarily increase bed capacity without a CON to
respond to COVID-19. See Amendment 3 (Apr. 14, 2020) to COVID-19 Disaster Order No. 2 (Mar. 31, 2020). The Governor’s temporary CON suspension expired on May 12, 2020.

Application Process

In Alaska, the CON application process usually takes 60–180 days. Alaska Stat. § 18.07.045. Applications can be submitted at any time. The fee for a CON application ranges from $2,500 to $75,000. 7 Alaska Admin. Code § 07.079. Competitors can intervene in the application process and can offer evidence or argument as to why an application should be denied. 7 Alaska Admin. Code § 07.082.

CON? Number of CONs Moratoria Temporary COVID-19 response:
Hospital Beds Yes 8 – Suspended at least some CON laws
Beds Outside Hospitals Yes 6 – No action
Equipment Yes 3 – No action
Facilities/ Buildings Yes 15 – No action
Services Yes 22 – No action
Emergency Medical Transport No – – –

Note: these citations are accurate as of May 2020.

Alaska CONs in Detail

Category 

Types of CONs 

Alaska Stat. 

Hospital Beds

 

A CON is required if a change in the following types of bed is made that costs more than $1.5 million.

Alaska Stat.

§ 18.07.031(a), (d)  

Alteration of the bed capacity of:

1.Private hospital. 

2.Municipal hospital.

3.State hospital.  

4.Federal hospital.

5.Psychiatric hospital.

§ 18.07.111(8) 

6.Tuberculosis hospital. 

§§ 18.07.031(a)(2), 

18.07.111(8) 

7.Acute care hospital. 

7 Alaska Admin. Code § 07.900(19)(B)(i) 

8.Critical access hospital. 

7 Alaska Admin. Code § 07.900(19)(B)(iii) 

Beds Outside Hospitals 

 

A CON is required if a change in the following types of bed is made that costs more than $1.5 million.

Alaska Stat.

§ 18.07.031(a), (d) 

Alteration of the bed capacity of a:

1.Independent diagnostic testing facility.  

2.Residential psychiatric treatment center. 

3.Skilled nursing facility.

4.Kidney disease treatment center (including freestanding hemodialysis units). 

5.Intermediate care facility. 

6.Ambulatory surgical facility. 

§ 18.07.111(8) 

Equipment 

1.Positron emission tomography.

Alaska CON Standards and Methodology, VII, B (Dec. 9, 2005)24

2.Computed tomography.

Alaska CON Standards and Methodology, VII, C

3.Magnetic resonance imaging.

Alaska CON Standards and Methodology, VII, A

Facilities/Buildings 

 

A CON is required if the construction of a facility will cost more than $1.5 million.

Alaska Stat.

§ 18.07.031(a), (d) 

1.Private hospital. 

2.Municipal hospital.  

3.State hospital.  

4.Federal hospital.  

5.Psychiatric hospital. 

§ 18.07.111(8)

6.Independent diagnostic testing facility. 

7.Residential psychiatric treatment center. 

8.Tuberculosis hospital. 

9.Skilled nursing facility.

10.Kidney disease treatment center (including freestanding hemodialysis units). 

11.Intermediate care facility.

12.Ambulatory surgical facility. 

§§ 18.07.031(a)(1),  

18.07.111(8)

13.Conversion of a building or part of a building to a nursing home, regardless of cost.  

See § 18.07.031(b) 

14.Construction of an acute care hospital. 

§ 18.07.031(a)(1);

7 Alaska Admin Code

§ 07.900(19)(B)(i) 

15.Construction of a critical access hospital. 

§ 18.07.031(a)(1);

7 Alaska Admin. Code § 07.900(19)(B)(iii) 

Services 

 

A CON is required if the following facilities add services that cost more than $1.5 million.

Alaska Stat.

§ 18.07.031(a), (d) 

Addition of a category of health services provided by a:

1.Private hospital.

2.Municipal hospital.

3.State hospital.

4.Federal hospital.

§§ 18.07.031(a)(3), 

18.07.111(8) 

5.Kidney dialysis program.

6.Radiotherapy.

7.Burn unit.

8.Neonatal intensive care services.

§ 18.07.111(1)

9.Laboratory services offered by a hospital.

Alaska CON Standards and Methodology, III, A.

10.Cardiac catheterization.

Alaska CON Standards and Methodology, VII, D.

11.Mobile diagnostic testing facility.

See 7. Alaska Admin. Code § 07.900(23)

12.Open-heart surgery.

Alaska CON Standards and Methodology, VIII, B

13.Addition of a category of health services provided by an acute care hospital. 

§ 18.07.031(a)(3); 

7 Alaska Admin. Code § 07.900(19)(B)(i) 
 

14.Addition of a category of health services provided by a critical access hospital. 

§ 18.07.031(a)(3); 

7 Alaska Admin. Code § 07.900(19)(B)(iii) 
 

15.Addition of a category of health services provided by a psychiatric hospital. 

§ 18.07.031(a)(3); 

7 Alaska Admin. Code § 07.900(19)(B)(ix) 
 

16.Addition of a category of health services provided by an independent diagnostic testing facility. 

§§ 18.07.031(a)(3), 

18.07.111(8) 

Services 

 

A CON is required if the following facilities add services that cost more than $1.5 million.

Alaska Stat.

§ 18.07.031(a), (d). 

Addition of a category of health services provided by a:

17.Residential psychiatric treatment center. 

18.Addition of a category of health services provided by a tuberculosis hospital. 

19.Addition of a category of health services provided by a skilled nursing facility. 

20.Addition of a category of health services provided by a kidney disease treatment center (including freestanding hemodialysis units). 

21.Addition of a category of health services provided by an intermediate care facility. 

22.Addition of a category of health services provided by an ambulatory surgical facility. 

§§ 18.07.031(a)(3), 

18.07.111(8) 

Emergency Medical Transport 

 No CONs in this category.

  

Alaska CON Exceptions

No CON Required For:  Alaska Stat. 
1.The Alaska Pioneers’ Home and the Alaska Veterans’ Home administered by the Department of Health and Social Services under Alaska Stat. 47-55.§ 18.07.111(8)(A) 
2.The offices of private physicians or dentists whether in individual or group practice.§ 18.07.111(8)(B); 7 Alaska Admin. Code § 07.001(b) 
3.The operator of an ambulatory surgical facility may relocate to a new site in the same community as long as the bed capacity and number of categories of health services provided at the new site stay the same.§ 18.07.031(c) 
4.The operator of an ambulatory surgical facility may make an expenditure of any amount in order to relocate to a new site in the same community as long as the bed capacity and number of categories of health services provided at the new site stay the same.§ 18.07.031(c) 

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