Washington, D.C. Certificate of Need Laws
Certificate of Need Intelligence
Washington, D.C.
90/100
Highly Restrictive
Year Enacted
—
Services Regulated
—
National Rank
43 of 51
Top Systems
- MedStar Health
- GW University Hospital
- Children's National
Reform Status
No Meaningful Reform
Key Case
No major case law on record.
Certificate of Need Investigation
01Scope of Regulation
7 Services. One Board. Zero Competition.
- ✓Hospitals
- ✓Ambulatory Surgery Centers (ASCs)
- ✓Nursing Homes / Long-Term Care
- ✓Home Health Agencies
- ✓Hospice
- ✓Imaging (MRI, CT, PET)
- ✓Major Medical Equipment
02The Application Process
90 Days on Paper. 12 Months in Practice.
Data sourced from state regulatory filings, public records, and independent analysis by The Rojas Report.
03Market Concentration
3 Systems. One Market.
MedStar Health
GW University Hospital
Children's National
Insurer Dominance
- Top Insurers
- CareFirst BlueCross BlueShield
- UnitedHealthcare
- Kaiser Permanente
- Explore our comprehensive analysis of CON laws across the United States.
Controls a dominant share of tertiary care via Washington Hospital Center & Georgetown University Hospital.
$81.4B in discounted drugs. Zero disclosure requirements.
05Legislative Environment
No Meaningful Reform
No Meaningful Reform
no significant reforms
Data sourced from state regulatory filings, public records, and independent analysis by The Rojas Report.
Last updated: April 2026