Virginias Certificate of Public Need Program In the early 1970s, there was a lot of concern about the rising costs of Medicaid and Medicare. In 1972, the Social Security Act began regulations to try to reign in these costs. The National Health Planning and Resources Development Act was passed in 1974. This Act required states to operate Certificate of Public Need (COPN) programs as a condition of receiving federal funding for health care. The federal COPN requirements were premised on providing orderly planning of health systems to meet the needs of the defined population and restricting the overbuilding of facilities, which was perceived as responsible for the high costs of medical services. The issues at the time of the issuance of this legislation were access to primary care, distribution of services in medically under-served areas, prevention, costs, utilization review, and education of the public in personal care and in use of the health care system.Virginia first enacted a COPN law in 1973, one year prior to the federal law requiring state COPN programs. The adoption of the COPN legislation marked the beginning of a new role for the Commonwealth in health care regulation. The State became the regulator of development for all nonfederal medical facilities. For the first time, owners of such facilities were required to obtain prior state approval before undertaking large capital expenditures, an alteration in bed capacity, or a change in service. The Virginia COPNs objectives included promotion of comprehensive health planning, promotion of the highest quality of health care at the lowest possible cost, the avoidance of unnecessary duplication of medical care facilities, and the provision of an orderly administrative procedure for resolving questions concerning the necessity of construction or modification of medical care facilities.The Virginia COPN process begins with the applicant filling out an extensive application. ...
