PROVIDENCE – Rhode Island’s recently enacted fiscal year 2027 state budget brings significant changes to the state’s determination of need laws, which supporters say is aimed at improving access to healthcare services.
The budget includes amendments to Rhode Island General Laws “Determination of Need for New Healthcare Equipment and New Institutional Health Services” statute that significantly narrow the categories of healthcare services and equipment requiring Certificate of Need review by the R.I. Department of Health.
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The legislation also raises the expenditure threshold for new facility construction to $50 million and removes several types of healthcare facilities, including home health agencies and drug treatment centers, from the categories subject to review.
“Determination of need laws don’t protect patients – they protect incumbents,” said Jaimie Cavanaugh, senior state policy counsel with Pacific Legal Foundation, which advocates against government regulations that hinder access to essential services. “Rhode Island families deserve access to the care they need, and that means letting providers build, compete and innovate without forcing them to first get permission from their competitors.”
Previously, Rhode Island’s determination of need program required healthcare providers to demonstrate a “need” for new services before regulators would allow them to operate. This process allowed existing hospitals and health systems to influence the entry of competitors into the market.
The recent reforms are designed to facilitate access to a broader range of services while maintaining oversight for specialized procedures such as cardiac catheterization and organ transplants.
The reforms were enacted as part of the fiscal 2027 budget, with support from the Pacific Legal Foundation, Gov. Daniel J. McKee’s office, Americans for Prosperity, and the Institute for Justice.
The Pacific Legal Foundation aims to roll back certificate of need laws nationwide, advocating against government regulations that hinder access to essential services.
Christopher Allen is a PBN staff writer. You may contact him at Allen@PBN.com.
