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  CERTIFICATE OF NEED INTELLIGENCE BRIEF: WEST VIRGINIA
  The Rojas Report | conlaws.rojasreport.com/states/west-virginia/
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  State:    West Virginia (WV)
  Score:    100/100
  Tier:     Most Restrictive
  Rank:     43 of 51 jurisdictions

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  KEY METRICS
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           23+  Services regulated by CON
          1977  Year CON enacted
           56%  340B hospitals under WVU Medicine
         13-12  Vote that killed CON repeal (2025)

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  SUMMARY
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  West Virginia CON score 100/100 (most restrictive). 23+ services regulated
since 1977. WVU Medicine and CAMC dominate the market. CON repeal failed by a
single vote in 2025.

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  SCOPE OF REGULATION
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  * Services Requiring CON Approval

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  APPLICATION PROCESS
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  Data sourced from West Virginia Health Care Authority, IRS Form 990 filings
(ProPublica Nonprofit Explorer), Cardinal Institute for West Virginia,
Leapfrog Group, Mountain State Times, West Virginia Watch, Federal Trade
Commission, and Department of Justice.

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  MARKET CONCENTRATION
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  WVU Medicine lost $30.5 million in 2023 but paid its CEO $3.96 million. CAMC
earned $34.9 million in profit but paid its CEO only $1.07 million. When
financial loss is rewarded with higher pay, market forces are not at play.

  Three systems control 100% of Louisville's inpatient market. Pricing reaches
354% of Medicare.

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  REFORM STATUS
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  HB 2013: The CON Repeal That Died by One Vote

  13-12 to kill the bill

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