ittee then formulates a formal recommendation that is submitted to the Commissioner of Health. The Commissioner then approves or denies the application. Once the Commissioner has approved or denied an application, his decision is communicated by letter to the applicant. From start to finish, the COPN process takes about one year.If an applicant is not pleased with the Commissioners decision, they have thirty days to appeal. The appeal process has four levels. The first level has the Commission reconsider his decision. Level II is a formal evidentiary hearing. The third level of appeal for the COPN process is a formal independent hearing. The last appeal option open to the applicant is to have a court to review the Commissioners decision. Appeals are usually based on the complaint that the Commissioner had some sort of favoritism in his ruling.The COPN process has brought a better distribution of health resources, but it hasnt controlled the rising health care rates. It has not slowed inappropriate utilization of facilities and services. The COPN process was flawed from the beginning. One defect was the way the process put emphasis on high-cost technologies with no attention to low-cost technologies. The high volume use of low-cost technology has caused a continuing rise in health care cost. The COPN process also does not consider operating costs associated with installing and using the technology. Medical facilities have gotten around the COPN process as it evidenced by their rise in total assets per bed.The inability of the COPN process to achieve its fundamental goal, the slowing of capital expansion and overall cost growth, ultimately led to its decline. In 1986, the federal government repealed its requirement for states to have COPN programs. In 1991, only 39 states still had these programs. During the 2000 Virginia General Assembly Session, a large number of bills were introduced either repealing COPN outright or ...
