Which states have CON laws? A breakdown

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Certificate-of-need laws require healthcare providers to get approval from state regulators before expanding facilities or investing in technology. 

New York became the first state to enact a CON law for healthcare services in 1964. Several other states implemented programs the following decade. Now, many states have CON laws, though they vary drastically. 

Some states, for example, place a dollar threshold on when a hospital or provider needs to file an application for review, while others only regulate nursing homes or long-term care facilities. 

Based on a fact sheet from the National Conference of State Legislatures, 35 states currently have a CON program. 

In addition to the District of Columbia, the following states have a CON law for healthcare facilities:

Alabama
Alaska
Arkansas
Connecticut
Delaware
Florida* 
Georgia
Hawaii
Illinois
Indiana
Iowa
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Mississippi
Missouri
Montana
Nebraska
Nevada
New Jersey
New York
North Carolina
Ohio
Oklahoma
Oregon
Rhode Island
South Carolina
Tennessee
Vermont
Virginia
Washington
West Virginia

* As of 2019, Florida general hospitals —including acute care facilities, long-term care facilities, and rural hospitals  — are no longer subject to CON approval, though the program still exists for other providers like hospices and children's hospitals.

The following states don't have a CON law:

Arizona*
California
Colorado
Idaho
Kansas
Minnesota*
New Hampshire
New Mexico
North Dakota
Pennsylvania
South Dakota
Texas
Utah
Wisconsin*
Wyoming

*Arizona, Minnesota and Wisconsin do not have an official certificate of need program, but maintain various approval processes that function similar to a CON law. 

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