A recent bill proposed by the Pennsylvania House of Representatives would, among other things, reinstate the Certificate of Need (CON) program in Pennsylvania.  Specifically, House Bill 305, introduced on February 7, 2007, would require anyone proposing to make capital expenditures in excess of $500,000 for replacement technology or $1,000,000 for equipment or improvements in connection with a covered health care facility, to obtain a CON.  Facilities subject to the CON requirements would include, among others, ambulatory surgery centers, imaging centers and cancer treatment centers using radiation therapy. 

Of even more concern to physicians is the fact that the legislation includes self-referral prohibitions similar to the federal Stark statute that would prohibit physicians from referring to health care entities (including ASCs which are not currently covered by Stark) in which they have a financial interest.  All physicians with ancillary service arrangements in Pennsylvania need to pay close attention to this and other efforts by State legislators to curb physician investment in ancillary services.