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  CERTIFICATE OF NEED INTELLIGENCE BRIEF: WASHINGTON, D.C.
  The Rojas Report | conlaws.rojasreport.com/states/washington-dc/
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  State:    Washington, D.C. (DC)
  Score:    90/100
  Tier:     Highly Restrictive
  Rank:     43 of 51 jurisdictions

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  SUMMARY
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  In-depth analysis of the District of Columbia's Certificate of Need (CON)
laws, market concentration, and the impact on healthcare access and cost.

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  SCOPE OF REGULATION
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  * Regulated Services
  * Ambulatory Surgery Centers (ASCs)
  * Diagnostic Imaging Facilities (MRI, CT, PET)
  * Nursing Homes & Long-Term Care
  * Home Health Agencies
  * Hospice Providers
  * Major Medical Equipment Purchases

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  APPLICATION PROCESS
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  The Application Gauntlet

  6-12 months (in practice)

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  MARKET CONCENTRATION
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  Controls a dominant share of tertiary care via Washington Hospital Center &
Georgetown University Hospital.

  $81.4B in discounted drugs. Zero disclosure requirements.

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  REFORM STATUS
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  no significant reforms

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  Source: The Rojas Report | conlaws.rojasreport.com/states/washington-dc/
  Data: Cicero Institute, NASHP, FTC, DOJ, CMS, state health departments
  Generated: April 2026
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