============================================================================== CERTIFICATE OF NEED INTELLIGENCE BRIEF: NEW JERSEY The Rojas Report | conlaws.rojasreport.com/states/new-jersey/ ============================================================================== State: New Jersey (NJ) Score: 100/100 Tier: Most Restrictive Rank: 43 of 51 jurisdictions ------------------------------------------------------------------------------ KEY METRICS ------------------------------------------------------------------------------ 1971 Year CON enacted 71% Top insurer market share $18.5B Revenue of top 2 systems ------------------------------------------------------------------------------ SUMMARY ------------------------------------------------------------------------------ New Jersey CON score 100/100 (most restrictive). Delays average 213 business days for 'expedited' reviews. Two systems control a significant portion of the market, with one insurer holding 71% market share. ------------------------------------------------------------------------------ SCOPE OF REGULATION ------------------------------------------------------------------------------ * Services Requiring CON Approval * Newton Medical Center Psychiatric Beds ------------------------------------------------------------------------------ APPLICATION PROCESS ------------------------------------------------------------------------------ The case demonstrates the immense power of the state agency within the CON process. Even after a project has been deemed necessary and approved, it can be blocked years later, leaving community health needs unmet and illustrating how CON can stifle the development of essential services. The 1998 reform created exemptions for certain services like ambulatory surgery and PET scans, but it preserved the CON requirement for new hospitals, specialized services, and long-term care, protecting the most lucrative revenue streams for incumbent systems. ------------------------------------------------------------------------------ MARKET CONCENTRATION ------------------------------------------------------------------------------ Of the top two hospital systems, RWJBarnabas and Hackensack Meridian. The 1998 reform created exemptions for certain services like ambulatory surgery and PET scans, but it preserved the CON requirement for new hospitals, specialized services, and long-term care, protecting the most lucrative revenue streams for incumbent systems. ------------------------------------------------------------------------------ REFORM STATUS ------------------------------------------------------------------------------ The 1998 reform created exemptions for certain services like ambulatory surgery and PET scans, but it preserved the CON requirement for new hospitals, specialized services, and long-term care, protecting the most lucrative revenue streams for incumbent systems. States that have fully repealed their CON laws have seen increased competition, lower costs, and better access to care, particularly in rural areas. They demonstrate that a free market in healthcare delivery is possible and beneficial. ------------------------------------------------------------------------------ CASE LAW / DENIALS ------------------------------------------------------------------------------ In a striking example of bureaucratic obstruction, the New Jersey Department of Health denied an extension for a previously approved Certificate of Need for Newton Medical Center to add 9 new psychiatric beds. The initial CON had been granted, acknowledging the need for expanded mental health services in the community. The case demonstrates the immense power of the state agency within the CON process. Even after a project has been deemed necessary and approved, it can be blocked years later, leaving community health needs unmet and illustrating how CON can stifle the development of essential services. Explore the case of Kentucky, one of the most restrictive CON states in the nation. ============================================================================== Source: The Rojas Report | conlaws.rojasreport.com/states/new-jersey/ Data: Cicero Institute, NASHP, FTC, DOJ, CMS, state health departments Generated: April 2026 ==============================================================================