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Navigating Michigan’s Certificate of Need Process: What You Need to Know

Serj Mooradian, Hannah Zaskiewicz and Seyed Mirabedini, Mooradian Law PLLC  /  January 30, 2025

Expanding or modifying healthcare services in Michigan often requires compliance with Certificate of Need (CON) regulations. These rules are designed to control costs and ensure equitable access to services, but the application process can be complex and time-sensitive. At Mooradian Law, we help healthcare providers navigate the CON process efficiently, minimizing risks and delays. This guide provides an overview of Michigan’s CON program and how to streamline your application. 

What is a Certificate of Need? 

Michigan’s CON program ensures that healthcare services are developed based on community needs while controlling costs and preventing duplication. Healthcare providers must obtain a CON before initiating certain projects. The Michigan Department of Health and Human Services (MDHHS) administers the program.

Does Your Project Require a Certificate of Need?

Many healthcare projects require a CON, regardless of cost. These include: 

  • Increase of Licensed Beds: Any project that increases the number of licensed beds at a healthcare facility. 
  • Relocation or Replacement of Licensed Beds: Moving a facility, moving beds from one licensed site to another, or changing the location of beds at the same licensed site. 
  • Acquisition of an Existing Health Facility: Purchasing an existing health facility.
  • Starting a New Health Facility: This includes hospitals, psychiatric hospitals or units, nursing homes, and freestanding surgical outpatient facilities (ambulatory surgery centers).
  • Initiation, Replacement, or Expansion of Covered Clinical Services: This includes MRI, CT and PET scanners, and cardiac catheterization.
  • Extended Care Services Program (Swing Beds): Beds that can be used flexibly for acute care and skilled nursing care. 

Additionally, capital expenditure projects (construction, renovation, etc.) require a CON if they exceed a certain threshold. As of January 1, 2025, the threshold is $4,175,000 for clinical service areas. 

Not sure if your project requires a CON? Contact us for a consultation.

What Falls Under CON Review Standards? 

The CON Commission, an 11-member independent body appointed by the Governor, develops and approves review standards for various healthcare services. These include: 

  • Bone Marrow Transplants 
  • Cardiac Catheterization
  • Computed Tomography (CT) Scanners
  • Heart, Lung, Liver Transplants
  • Hospital Beds
  • Magnetic Resonance Imaging (MRI)
  • Megavoltage Radiation Therapy (MRT)
  • Neonatal Intensive Care Units (NICU)
  • Nursing Home/Hospital Long-Term Care Unit Beds (NH/HLTCU)
  • Open Heart Surgery
  • Positron Emission Tomography (PET) Scanners
  • Psychiatric Beds: Acute Inpatient
  • Surgical Services
  • Urinary Lithotripters 

How to Navigate the CON Application Process 

The CON application process involves several key steps: 

 1. Letter of Intent: File a Letter of Intent (LOI) with MDHHS. Based on the information provided, MDHHS will notify you of the required application forms. 

 2. Application Submission: Submit a CON application. Within 15 days, MDHHS will review it for completeness and request additional information.

 3. Review Period: MDHHS will deem the CON application complete upon receipt of your response to its request for additional information; then the review period starts. 

  • Nonsubstantive (45 days): For simpler projects, such as equipment replacements. 
  • Substantive (120 days): For detailed reviews, like initiating a MRI service.
  • Comparative (150 days): For projects competing for limited resources, with applications accepted in specific filing periods (February 1, June 1, October 1).

 4. Proposed and Final Decisions: MDHHS will issue a proposed decision by the end of the review period. The Director of MDHHS will sign a final decision within five days of the proposed decision. If denied, applicants have 15 days to request a hearing. 

Let Mooradian Law help you ensure your application is complete and optimized for approval. 

CON Filing Fees 

CON application fees depend on the total project cost: 

  • $0 to $500,000: $3,000 
  • $500,000 to $4,000,000: $8,000
  • $4,000,000 to $10,000,000: $11,000
  • $10,000,000 or more: $15,000 

Additional fees: 

  • Comparative or complex reviews: $3,000 
  • Expedited reviews: $1,000
  • Amendment requests or LOI waivers: $500 

Tips for Navigating the CON Process 

Successfully navigating Michigan’s CON process requires strategy. Here are our tips for success: 

  • Start Early: Timing is crucial. We assess feasibility and submit applications well in advance. 
  • Prepare Thoroughly: Our team ensures all documents are accurate and compelling to reduce the risk of delays.
  • Engage with the Community: Demonstrating local support can strengthen your application.
  • Seek Professional Guidance: With years of experience handling CON applications, Mooradian Law provides strategic guidance to help you achieve your goals efficiently. 

Final Thoughts: Why Work with Mooradian Law? 

Understanding Michigan’s CON requirements is essential for healthcare providers looking to expand or initiate services. At Mooradian Law, we specialize in guiding healthcare professionals through Michigan’s CON process with efficiency and expertise. Whether you’re expanding a facility, launching a new service, or acquiring a healthcare center, we ensure your application is strategically positioned for approval. 

Contact us today for a consultation: 

📧 info@mooradian.law 

📞 (734) 219-4890