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Bill

HB 4223

Relating to authorizing the Department of Health to promulgate a legislative rule relating to the exemption of Certificate of Need.

2026 Regular Session Introduced by Doug Smith

Bill authorizes West Virginia's health department to create rules defining Certificate of Need exemptions, shifting healthcare facility approval authority from legislature to regulatory agency.

To House Health and Human Resources
#legislature--rulemaking
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Bill Summary · HB 4223

Legislative bill overview

HB 4223 authorizes West Virginia's Department of Health to create regulatory rules governing exemptions from Certificate of Need (CON) requirements. CON laws require healthcare facilities to obtain state approval before making major capital expenditures or service expansions. This bill delegates rule-making authority to the health department rather than requiring the legislature to specify exemption criteria in statute.

Why is this important

Certificate of Need regulations significantly impact healthcare access and costs by controlling facility expansion and competition. How exemptions are defined affects which healthcare providers can operate without state approval, influencing market entry, service availability, and healthcare spending in the state. The bill essentially shifts policy-making power from the legislature to an executive agency.

Potential points of contention

  • Delegation concerns: Critics may argue this grants excessive regulatory authority to the executive branch without specific legislative guidance on what exemptions should cover
  • Market access debate: Healthcare industry groups may clash over whether broad exemptions increase competition and access (pro-business view) or undermine planning and equity (pro-regulation view)
  • Lack of specificity: The bill provides no details on exemption scope, potentially allowing administrative discretion that could favor certain providers or regions over others

Compiled from official sources — confirm details with the bill’s official record.

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