A Boone County Republican, is once again sparring with Kentucky hospitals over what's called certificate of need.

That's the law that regulates how many medical providers can offer certain services based on the size and needs of the local population.

As our June Lefler reports, lawmakers have to decide if the status quo or shakeup in the medical marketplace will help or hurt patients.

Certificate of need was nationwide until 1987.

The what the government was doing was artificially reducing the amount of beds, health care providers because they were worried about increasing health care costs, about duplication of services and quality.

Since then, states have decided to keep or alter this practice.

15 states have repealed it.

Arguably with success.

There are five states that have been studied that don't have certificate need for rural hospitals, and those are Colorado, Idaho, Oregon, Utah and Wyoming.

And they have had zero closure since they did away with their loss.

This isn't certainly an effort to close hospitals.

I actually think when you're looking at certificate of need and across the board of different reforms, what we're really trying to do is equip both existing providers and new providers to be able to offer the services that are needed and wanted at the time.

That's why this state lawmaker wants to alter, though, not abandon, a law.

She says keeps competition out of health care.

It does not repeal Certificate of Need yet streamline the process.

Kentucky's hospitals have consistently lobbied against changes to certificate of need or Con, citing financial concerns.

And what that will do, in particular to Saint Elizabeth is it will harm safety net hospitals.

So Saint Elizabeth in northern Kentucky, we are the safety net hospital.

And by that I mean we provide a high volume of low income, uninsured and publicly insured patients, regardless of their ability to pay.

Medical providers have to apply to the state whenever they want to offer new services in an area.

House Bill 407 would prevent hospitals or other third parties from contesting those applications.

And so all that we're trying to do here is make sure that the process that the cabinet has for the state of Kentucky has approved is thorough and is fair.

That right to request a hearing is now being given only to the applicant for comment.

And our concern is, why would an applicant ever request a hearing to oppose its own application?

A Lexington Democrat says the status quo needs to change.

But when a corporation or a hospital, whether they're for profit or not, for profit, is directly impacted by a decision of the government, they need a right of appeal because the government is not always right.

The House Health Services Committee did pass the bill with a cautious yes vote from the chair.

It's difficult because health care is not really a free market enterprise.

It's not like going to the corner store and and you know, buying the same apples in each store.

I just want to make sure that we're not driving up the cost of health care.

We need to improve access.

Of course.

We need to maintain quality.

Of course we need to maintain credentialing and all of the things that factor into this House.

Bill 407 passed in a 10 to 5 vote.

It now heads to the full House.

For Kentucky edition, I'm Jen Leffler.

Thank you, John, for that.

The committee also passed House Bill 713 regarding the verbal and physical harm sometimes inflicted on health care workers.

Republican Jason Nemeth sponsors that bill.

The Kentucky Nurses Association testified today in support of it.

It requires hospitals to better track and respond to workplace violence.

The bill does not alter penalties for harassment or assault, which can be felony offenses.