============================================================================== CERTIFICATE OF NEED INTELLIGENCE BRIEF: VIRGINIA The Rojas Report | conlaws.rojasreport.com/states/virginia/ ============================================================================== State: Virginia (VA) Score: 100/100 Tier: Most Restrictive Rank: 43 of 51 jurisdictions ------------------------------------------------------------------------------ KEY METRICS ------------------------------------------------------------------------------ 19 Services regulated by CON 1973 Year CON enacted 17.71% Top Insurer Market Share Highly Concentrated Northern VA Hospital Market ------------------------------------------------------------------------------ SUMMARY ------------------------------------------------------------------------------ Virginia CON score 100/100 (Most Restrictive). 19 services regulated since 1973. See how the law impacts healthcare access and cost. ------------------------------------------------------------------------------ SCOPE OF REGULATION ------------------------------------------------------------------------------ * Services Requiring CON Approval * MRI Machine Denial ------------------------------------------------------------------------------ KEY HEALTH SYSTEMS ------------------------------------------------------------------------------ Sentara Health Revenue: $13B Inova Health System Revenue: $6.5B UVA Health System Revenue: $5.6B ------------------------------------------------------------------------------ MARKET CONCENTRATION ------------------------------------------------------------------------------ A few large systems control the majority of hospital revenue in Virginia, a sign of a concentrated market. ------------------------------------------------------------------------------ REFORM STATUS ------------------------------------------------------------------------------ Current State: No Meaningful Reform Despite numerous attempts, Virginia's COPN law remains largely intact. Bills to repeal or significantly reform the law have consistently failed in the General Assembly, often due to strong opposition from the hospital lobby. ============================================================================== Source: The Rojas Report | conlaws.rojasreport.com/states/virginia/ Data: Cicero Institute, NASHP, FTC, DOJ, CMS, state health departments Generated: April 2026 ==============================================================================