Certificate of Need Laws in Illinois — What Patients Need to Know
Illinois is one of the states that maintains a comprehensive Certificate of Need (CON) program, requiring healthcare providers to obtain state approval before building new facilities, expanding existing ones, or acquiring certain costly medical equipment. First enacted in 1974, the state’s CON law has been amended multiple times, most recently in 2023, and continues to shape how healthcare services are delivered across Illinois. This explainer presents both sides of the debate and what CON laws mean for patients in the state.
ILLINOIS — KEY FACTS
| CON Law Status | ACTIVE CON LAW |
| Programme Scope | active |
| Year Enacted | See agency |
| Services Requiring Approval | hospitals, nursing homes, ambulatory surgery centres, imaging equipment (MRI/CT), dialysis facilities, hospice providers, psychiatric facilities, home health agencies |
| Governing Agency | Illinois Health Facilities and Services Review Board |
| Hospitals in State (CMS data) | Data not available |
The Arguments
WHAT SUPPORTERS ARGUE
Defenders of Illinois’s CON laws argue that the review process helps prevent unnecessary duplication of expensive healthcare services, which could drive up costs for patients and insurers. They contend that CON oversight helps ensure that new facilities and services are distributed equitably across the state, including in underserved and rural communities that might otherwise be overlooked by market-driven expansion. Proponents also maintain that the regulatory framework supports quality of care by ensuring that providers meet established volume and safety thresholds before offering complex services.
WHAT CRITICS ARGUE
Critics of Illinois’s CON laws argue that requiring state approval to open or expand healthcare facilities limits competition, which can lead to higher prices and reduced patient choice. They contend that the approval process can be slow, costly, and burdensome, potentially discouraging new market entrants and innovation in healthcare delivery. Some opponents also argue that existing providers may use the CON process to block competitors, effectively protecting their market share rather than serving the public interest.
The Data
WHAT THE DATA SHOWS IN ILLINOIS
No CMS hospital data is currently available for Illinois in this analysis. Illinois’s CON program covers an unusually broad scope of services — including hospitals, nursing homes, ambulatory surgery centers, imaging equipment, dialysis facilities, hospice providers, psychiatric facilities, and home health agencies — making it one of the more comprehensive CON programs in the nation.
Recent Developments
In 2023, Illinois updated its Certificate of Need rules to include new technology thresholds, reflecting changes in the healthcare landscape and the growing role of advanced medical equipment. These amendments were designed to modernize the review process and adjust the criteria under which providers must seek state approval. The Illinois Health Facilities and Services Review Board continues to oversee the implementation of these updated regulations.
What This Means For Patients in Illinois
For patients in Illinois, the CON law means that the availability and location of many healthcare services — from hospital beds to imaging centers to home health agencies — are shaped in part by a state approval process rather than market forces alone. Whether this results in better access and lower costs, or reduced competition and fewer choices, remains a point of active policy debate.
THE BOTTOM LINE
Illinois maintains one of the nation’s more comprehensive Certificate of Need programs, and the ongoing debate centers on whether state oversight of healthcare facility expansion better serves patients through coordinated planning or limits their options by restricting competition.
Frequently Asked Questions
Does Illinois have a Certificate of Need law?
Yes, Illinois has had a Certificate of Need law since 1974, and it was most recently amended in 2023. The law is full in scope and is administered by the Illinois Health Facilities and Services Review Board.
What services require CON approval in Illinois?
Illinois requires CON approval for a wide range of healthcare services, including hospitals, nursing homes, ambulatory surgery centers, imaging equipment (MRI and CT scanners), dialysis facilities, hospice providers, psychiatric facilities, and home health agencies. The 2023 amendments also introduced new technology thresholds that may trigger the approval requirement.
How do Illinois CON laws affect hospital costs?
Proponents argue that CON laws help control costs by preventing the duplication of expensive services and excess capacity, while critics contend that reduced competition can lead to higher prices. No CMS hospital cost data specific to Illinois is currently available in this analysis to quantify the effect.
Can I find out if a facility has CON approval in Illinois?
Yes, the Illinois Health Facilities and Services Review Board maintains records of CON applications and approvals. You can visit their website at https://hfsrb.illinois.gov for more information on approved projects and pending applications.