Alaska Certificate of Need Requirements: Facility Guide
Alaska is one of 35 states that requires healthcare providers to obtain a certificate of need (CON) before building or expanding operations. These programs were introduced to reduce healthcare spending by preventing redundant services. The Alaska certificate of need program has undergone several modifications since its inception, but still serves to ensure healthcare infrastructure doesn’t inflate beyond actual need.
If you’re considering opening a healthcare facility in Alaska, here’s an overview of the CON requirements that you may need to fulfill before breaking ground.
Alaska Certificate of Need Laws and Regulations at a Glance
Obtaining a CON from Alaska’s Department of Health can be time consuming and expensive. To help you understand the basics of the process, we’ve outlined some of the key provisions and provided helpful links and resources.
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| Legal Authorities | Alaska Statutes, Title 18, Chapter 7:
Alaska Administrative Code, Chapter 7:
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| Requirements | While certain exceptions exist, in Alaska CON approval is generally required for the expenditure of $1.5 million or more (as defined by part (d) of section 18.07.031) spent on:
Note: Conversion of part (or all) of a building into a nursing home requires a CON for any proposed project, regardless of cost. Facilities that are regulated by Alaskan CON laws can include:
Institutions and services that are exempt under section 18.07.111 may include:
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| State Agency | Alaska Department of Health |
| Fees | Under 7 AAC 07.079, the mandatory, nonrefundable application fee is:
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| Application Forms | To apply for a CON — as outlined by 7 AAC 07.040 — the healthcare provider must:
Once the application is received, the state will issue a public notice of the program’s intentions (bed capacity expansion or new facility construction, for example). This public forum allows competitors the chance to submit a letter of intent if they plan to challenge the original CON request to begin or expand their own similar project. |
| Penalties | There is no standard monetary penalty associated with the Alaska CON application process. However, failure to comply with CON laws and regulations, or to demonstrate progress toward approved expansion (once the CON is issued), can cause the State to revoke an approval.
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A Brief History of Alaska’s Certificate Program
California was the first state to enact CON laws. A decade later, the federal government followed their lead, introducing the National Health Planning and Resources Development Act in 1974. This statute put certain federal funding in jeopardy for states that didn’t have CON programs. With federal assistance at stake, Alaska introduced its own CON laws two years later.
After the federal mandate was repealed with bipartisan support, Alaska maintained its program but did remove the federal requirements from its laws in 1991. Statutory modifications were later added in 1997 and 2004.
Controversy Around the Certificate of Need
Alaska has some of the highest healthcare spending costs in the country, while also suffering from frequent suboptimal health outcomes. Many agencies — including the Federal Trade Commission and the Department of Justice’s Antitrust Division — argue that the repeal of its CON laws would help address these issues. Yet the complexity of the matter, especially for a state as unique as Alaska, means that a simplified pros and cons of certificate of need laws approach is unlikely to lead to productive conclusions.
While repealing Alaska’s CON laws could help boost a free market approach for healthcare providers, the state is also known for having a very concentrated insurance market. Driving competition among providers may affect their bargaining power within those limited contracts, hurting their bottom line and ability to operate. These are just some of the factors that lawmakers must consider when attempting to help enable improvements to Alaska’s healthcare infrastructure.
Want More Answers to Your Complex Healthcare Questions?
The benefit of the Alaska certificate of need requirement is one of many complex healthcare topics. For answers to your pressing questions — whether they’re about regulatory issues or productivity improvement — Intelycare has you covered with expert-backed resources, guides, and insights.
Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.