Last revised date: July 18, 2025
Revised Code of Washington (RCW) statutes
Certificate of Need (RCW 70.38)
Acquisition of Non-Profit Hospitals (RCW 70.45)
Antitrust Immunity (RCW 43.72)
Washington Administrative Code (WAC) rules
Certificate of Need (WAC 246-310)
Acquisition of Non-Profit Hospitals (WAC 246-312)
Antitrust Immunity (WAC 246-25)
Current Rules in Progress
- Proviso Report
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Background
The Department of Health was allocated funds to analyze the Certificate of Need program and report findings to the legislature and Governor by June 30, 2025. The report will explore other states' strategies, healthcare access, cost management, equity, and methods for identifying service needs. A research firm with expertise in healthcare economics and data analytics has been contracted with to assist with research and recommendations.
Preliminary Findings Presentations
BerryDunn presented on the preliminary findings for modernizing the CN program on three separate dates. A recording of these presentations is available upon request.
You may also view the Preliminary Findings Presentation (PDF)
Presentation Date and Time #1 Wednesday, November 13, 2024, 9 a.m. - 11 a.m. #2 Tuesday, November 19, 2024, 2 p.m. - 4 p.m. #3 Wednesday, November 20, 2024, 10 a.m. - 12 p.m. Past Workshops
To access comments related to this work email the Certificate of Need rules team.Workshop Date and Time #1 Tuesday, July 30, 2024, 9 a.m. - 11 a.m. #2 Thursday, August 1, 2024, 4 p.m. - 6 p.m. #3 Wednesday, August 7, 2024, 9 a.m. - 11 a.m. #4 Thursday, August 8, 2024, 4 p.m. - 6 p.m. #5 Thursday, September 19, 2024; 11 a.m. - 1 p.m. #6 Tuesday, October 1, 2024; 9 a.m. - 1 p.m. #7 Wednesday, October 8, 2024; 10 a.m. - 12 p.m. - Percutaneous Coronary Intervention (PCI) Rules 2024-2025
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Background
The Department of Health (department) is considering changes to requirements for adult elective PCI programs in response to rule-making petitions.
In October 2023, the department received a petition (PDF) for rulemaking to amend WAC 246-310-720 Hospital volume standards. WAC 246-310-720(1) requires hospitals with elective PCI programs to perform at least 200 adult PCIs per year by their third year. WAC 246-310-720(2) only allows new elective PCI programs to enter a planning area if there are unmet volumes sufficient to establish another program and all existing elective PCI programs meet the minimum volume standard. The petition requests amendment of WAC 246-310-720(2), to eliminate the requirement that existing PCI programs in the planning area must meet the minimum volume standard before a new elective PCI program may be approved.
In 2019, a separate rule-making petition (PDF) was approved by the department that also requested amendment of WAC 246-310-720, as well as WAC 246-310-745. The department opened the CN rule chapter to address the petition, as well as other changes to CN rules. Ultimately, the department determined addressing CN rule amendments by facility type would be preferable to addressing the entire chapter at once. This rulemaking project will consider both petition requests.
The department will consider amendments proposed in petitions to WAC 246-310-720 and WAC 246-310-745. The department will also consider amendments to other PCI rules, WAC 246-310-700 through WAC 246-310-755, as part of this rule project.
Petitions
- 07/08/2019 Harborview's petition to amend WAC 246-310-720 and 246-310-745 (PDF)
- 10/06/2023 Providence's petition to amend WAC 246-310-720 (PDF)
Correspondence with UW Harborview regarding the 2019 Petition
- 09/03/2019 Department's response to Harborview's petition (PDF)
- 01/04/2023 Harborview's letter to the department (PDF)
- 01/04/2024 Harborview's letter to Dr. Shah (PDF)
- Attachment to 01/04/2024 letter, Harborview's Mission Statement (PDF)
- Attachment to 01/04/2024 letter, National Cardiovascular Data Registry Heat Map (PDF)
- 01/18/2024 Department's response to Harborview (PDF)
Draft Rules and Workbooks
Rule Activities
Public Comment
- 06/07/2024, from MultiCare Health System (PDF)
- 06/07/2024, from Providence (PDF)
- 10/25/2024, from MultiCare Health System (PDF)
Comments specific to a workshop topic are in the Past Workshop section below, along with articles and presentations provided by participants.
Rule Workshops, Presentations, and Documents
Past Workshops
Workshop Date, Time, and Topics Materials Received #1 Monday, June 10, 2024, 9 a.m. - noon
Topics:
General Provisions- 700 – Adult elective PCI without on-site cardiac surgery
- 705 – PCI definitions
- 710 – Concurrent review
None #2 Tuesday, July 9, 2024, 9 a.m. - 1 p.m.
Topics:
Methodology Presentations by Petitioners- UW Harborview
- Providence
- MHS
- 745 – Need forecasting methodology
- 750 – Tiebreaker
- 755 – Ongoing compliance with standards
Presentations:
#2.5 Wednesday, July 24, 2024, 9 a.m. - 11 a.m.
Topics:
- Publicly available data sources
- Consider updates to planning areas identified in WAC 246-310-705(5)
- Guiding principles for rulemaking
Journal of the American Heart Association, Government Regulation and Percutaneous Coronary Intervention Volume, Access and Outcomes: Insights from the Washington State Cardiac Care Outcomes Assessment Program (PDF) #3 Tuesday, August 6, 2024, 9 a.m. - 1 p.m.
Topics:
Rule-making processes Guiding Principles Need Methodology, continued- 745 – Need forecasting methodology
- 750 – Tiebreaker
- 755 – Ongoing compliance with standards
Guiding Principle Submissions:
- 07/24/2024, from Health Facilities Planning and Development (PDF)
- 08/05/2024, from MultiCare Health System (PDF)
#4 Tuesday, September 3, 2024, 9 a.m. - 1 p.m.
Topics:
Presentation by Corazon Review Workshop #3 Defining PCI Identifying Data Source Methodology Review- 745 - Need Forecasting Methodology
- 750 - Tiebreaker
- 755 - Ongoing Standards Compliance
PCI Presentations, Definition Submissions, and Meeting Notes:
- Presentations
- Definition suggestions
#5 Tuesday, October 1, 2024, 9 a.m. - 1 p.m.
Topics:
Presentation by COAP on PCI Data Presentation by COAP on Article (PDF) Presentation by External Stakeholder GroupPCI Presentations and rulemaking proposals:
- Presentations:
- Proposal:
#6 Tuesday, October 29, 2024, 9 a.m. - 1 p.m.
Topics:
- Presentation by External Stakeholder Group
- Alternative need models
PCI Presentations and materials:
- Presentations
#7
Thursday, December 5, 2024, 1p.m. - 3 p.m.
Topics:
- Community Presentations
PCI Presentations:
#8 Tuesday, December 17, 2024, 9 a.m. - noon
Topics:
- Community Presentations
- PCI Definition
- Data Source
PCI Presentations:
#9 Thursday, February 20, 2025, 9 a.m. - 11:30 a.m.
Topics:
- WAC 246-310-705 through 246-310-740
PCI Presentations:
#10 Friday, March 21, 2025, 9:30 a.m. - 11:30 a.m.
Topics:
- Need Methodology
- Concurrent review
- Tiebreaker
PCI Presentations and Materials:
#11 Tuesday, April 22, 2025, 1:30 p.m. - 4:30 p.m. Topics:
- Need Methodology
- Concurrent review
- Tiebreaker
PCI Presentations and Materials:
#12 Friday, May 16, 2025, 9:30 a.m. - 12:00 p.m.
Final rulemaking workshop.
Topics:- Final review of all sections
PCI Presentations and Materials:
More Agency Rule Resources
- Department of Health Rule Making
- State Board of Health rules
- Other Department rules in Washington Administrative Code Title 246
Contact and connect
- Visit our Contact Info & Partner Programs page for Certificate of Need Program contact and mailing information.
- To receive updates from the Certificate of Need Program, subscribe at the bottom of this page.