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H 7392Medical Services

Health and Safety - Determination of Need for New Healthcare Equipment and New Institutional Health Services

This bill establishes specific application fees and a maximum price cap for healthcare providers seeking approval for specialized medical services.

Held for study
Population
Affected
25
Email Legislator
Introduced Jan 28, 2026Committee House Finance

Plain-English Summary

This legislation updates the fee structure for healthcare providers applying for a "certificate of need" (CON) in Rhode Island. A CON is a regulatory approval required before a healthcare facility can expand or offer new services. Specifically, for applications regarding "tertiary or specialty care services" (such as complex medical procedures or specialized units), the bill establishes a base fee of $10,000 plus a percentage of the project's capital costs. However, the bill places a maximum limit of $25,000 on this fee. Facilities owned by the state remain exempt from paying these application fees.

For younger readers

Imagine a hospital wants to build a new special room for very sick patients. Before they can build it, they have to ask the state government for permission. This permission costs money, like buying a ticket. This bill says that for very special types of hospital projects, the ticket costs $10,000 plus a little bit more based on how expensive the building is. But, the bill also says the ticket price cannot go higher than $25,000, no matter how big the project is. This helps hospitals know exactly how much they have to pay.

Who & Where It Applies

Impacted groups
HospitalsHealthcare SystemsSpecialty Care ProvidersDepartment of HealthPatients requiring tertiary care
Impacted communities
All

Constitutional & Fiscal Check

None Likely

Estimated cost
None
Estimated revenue
Amount unknown

Bill Analysis

Both viewpoints
For Progressives
  • Potentially encourages the expansion of specialized medical services by capping administrative costs, which could improve access to tertiary care for the community.
  • Ensures that financial resources within non-profit or community hospitals are directed toward patient care and infrastructure rather than excessive administrative fees to the state.
  • Maintains the state's oversight role through the certificate of need process while making the financial barrier to entry more predictable for healthcare providers.
  • Reduces potential revenue for the state general fund by placing a hard cap on fees for high-cost capital projects proposed by large healthcare systems.
  • Primarily benefits large corporate healthcare entities by lowering their regulatory costs, rather than directly assisting patients or low-income residents.
  • Could inadvertently encourage the consolidation of high-profit specialty services by lowering the financial barrier for expensive expansion projects, potentially at the expense of general care.
For Conservatives
  • Limits government revenue collection by placing a hard cap on specific regulatory fees, preventing the state from extracting excessive money from private enterprise.
  • Reduces the financial burden on healthcare businesses seeking to expand or modernize, potentially encouraging capital investment and economic activity.
  • Provides greater cost certainty for businesses attempting to navigate the state's regulatory bureaucracy.
  • Continues to support the "certificate of need" regulatory scheme, which interferes with the free market and restricts the ability of businesses to operate freely.
  • Maintains an unfair double standard by continuing to exempt state-owned facilities from fees that private businesses are forced to pay.
  • Does not eliminate the fee entirely, continuing the practice of charging businesses for the "privilege" of asking permission to improve their services.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 3 additions

SECTION 1. Section 23-15-10 of the General Laws in Chapter 23-15 entitled "Determination of Need for New Healthcare Equipment and New Institutional Health Services" is hereby amended to read as follows: 23-15-10. Application fees. The state agency shall require that any applicant for certificate of need submit an application fee prior to requesting any review of matters pursuant to the requirements of this chapter; except that health care facilities owned and operated by the state of Rhode Island shall be exempt from this application fee requirement. The application fee shall be paid by check made payable to the general treasurer. Except for applications that propose new or expanded tertiary or specialty care services as defined in subdivision 23-15-2(10)(vi), submission of any application filed in accordance with § 23-15-4(d) shall include an application fee of five hundred dollars ($500) per application plus an amount equal to one quarter of one percent (0.25%) of the total capital expenditure costs associated with the application. For an application filed in accordance with the requirements of § 23-15-5 (Expeditious review), the application shall include an application processing fee of seven hundred and fifty dollars ($750) per application plus an amount equal to one quarter of one percent (0.25%) of the total capital expenditure costs associated with the application. Applications that propose new or expanded tertiary or specialty care services as defined in subdivision 23-15-2(10)(vi), shall include an application fee of ten thousand dollars ($10,000) plus an amount equal to one quarter of one percent (0.25%) of the total capital expenditure costs associated with the application, which shall be limited to a total of twenty-five thousand dollars ($25,000). Application fees shall be non-refundable. All fees received pursuant to this chapter shall be deposited in the general fund.

SECTION 2. This act shall take effect upon passage.