Certificate of Need Laws in New York — What Patients Need to Know
New York has one of the most comprehensive Certificate of Need (CON) programs in the United States, requiring state approval before healthcare facilities can be built, expanded, or equipped with major medical technology. First enacted in 1964, New York’s CON law covers a wide range of healthcare services and is administered by the New York State Department of Health through its Public Health and Health Planning Council. Understanding how this regulatory framework works is important for patients navigating healthcare options and costs in the state.
NEW YORK — 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 | New York State Department of Health — Public Health and Health Planning Council |
| Hospitals in State (CMS data) | Data not available |
The Arguments
WHAT SUPPORTERS ARGUE
Defenders of New York’s CON laws argue that the program helps ensure healthcare resources are distributed equitably across the state, preventing an oversaturation of services in profitable urban markets while underserved communities go without. Proponents contend that requiring state approval helps maintain quality standards and prevents unnecessary duplication of expensive services, which could otherwise drive up costs across the healthcare system. They also argue that the review process gives regulators the ability to plan for the state’s healthcare needs in a coordinated manner.
WHAT CRITICS ARGUE
Critics of New York’s CON laws argue that the extensive approval process creates significant barriers to entry for new healthcare providers, ultimately reducing competition and potentially keeping prices higher for patients. They contend that incumbent healthcare facilities can use the CON process to block competitors from entering their markets, limiting patient choice. Some critics also point out that the lengthy and complex application process can delay access to new or expanded healthcare services, particularly in areas where demand is growing.
The Data
WHAT THE DATA SHOWS IN NEW YORK
New York’s CON program is among the most comprehensive in the country, covering hospitals, nursing homes, ambulatory surgery centers, imaging equipment (MRI/CT), dialysis facilities, hospice providers, psychiatric facilities, and home health agencies — a breadth of coverage that exceeds most other states with CON laws.
Recent Developments
New York last amended its Certificate of Need law in 2022, maintaining its position as one of the most active and comprehensive CON programs in the country. The state continues to require CON approval across a broad range of healthcare services and facilities, with oversight provided by the Public Health and Health Planning Council under the New York State Department of Health. No recent news coverage in the sources reviewed specifically addressed pending legislative changes to New York’s CON program.
What This Means For Patients in New York
For patients in New York, the full-scope CON law means that the opening of new healthcare facilities, the addition of major medical equipment, and the expansion of services all require state approval — a process that may affect the availability and timing of new healthcare options. Whether this regulatory oversight ultimately benefits patients through coordinated planning and quality assurance, or limits their choices and contributes to higher costs, remains a matter of ongoing policy debate.
THE BOTTOM LINE
New York maintains one of the broadest and most active Certificate of Need programs in the nation, and the debate over whether this regulatory framework best serves patients by ensuring quality and equitable access or hinders them by limiting competition and choice continues among policymakers, providers, and patient advocates.
Frequently Asked Questions
Does New York have a Certificate of Need law?
Yes, New York has a full-scope Certificate of Need law that has been in effect since 1964. It is one of the most comprehensive CON programs in the United States and was last amended in 2022.
What services require CON approval in New York?
New York’s CON law covers a wide range of healthcare services, including hospitals, nursing homes, ambulatory surgery centers, imaging equipment such as MRI and CT scanners, dialysis facilities, hospice providers, psychiatric facilities, and home health agencies. This broad scope means that most major healthcare facility developments and service expansions in the state require prior approval.
How do New York CON laws affect hospital costs?
The effect of CON laws on hospital costs is debated. Proponents argue the laws help control costs by preventing unnecessary duplication of services, while critics contend that limiting competition may reduce downward pressure on prices — no CMS hospital cost data specific to New York is currently available in our dataset to offer a direct comparison.
Can I find out if a facility has CON approval in New York?
Yes, the New York State Department of Health oversees the CON process and provides information about facility approvals. Patients and the public can visit the department’s CON webpage at https://www.health.ny.gov/facilities/cons/ for details on applications and approved projects.