A new lawsuit has been filed against the Department of Social Services revolving around an appropriation of $15 million for the development of a radiation oncology center in Kirksville, Missouri, to be built by Hannibal Regional Hospital. The lawsuit alleges the appropriation is unlawful because Hannibal Regional Hospital did not have a certificate of need for its project prior to the legislature appropriating the funds.
During the 2024 legislative session, Missouri’s legislature passed House Bill 2011 (HB 2011), which included a one-time appropriation of $15 million to the Department of Social Services. This amount was earmarked for the planning, design, construction, and equipment of a radiation oncology center in Adair County by Hannibal Regional Hospital, not the local hospital facility known as Northeast Regional Medical Center.
The crux of the issue lies in Missouri’s certificate of need law, which mandates that any new healthcare facility must first receive approval from the Missouri Health Facilities Review Committee before any construction or equipment purchases can take place. The approval process involves demonstrating financial feasibility, and ensuring the project is necessary and viable.
On May 29, 2024, Hannibal Regional Hospital filed a Letter of Intent to acquire a linear accelerator, which is a key piece of equipment for radiation therapy, and subsequently filed a full application for the purchase and construction required. The hospital’s total project cost is approximately $6.98 million.
The lawsuit asserts that the state legislature violated Missouri statutes by appropriating taxpayer dollars for a health project without a valid certificate of need. Sections 197.355 and 197.315.5 of Missouri law expressly prohibit the allocation of funds for such healthcare facility expenditures before the necessary approvals are granted. Court filings argue the appropriation of funds for the radiation oncology center and its equipment was premature and unlawful since the necessary approval had not yet been obtained.
Hannibal Regional Hospital’s internal auditor cited the state’s $15 million allocation as proof of financial feasibility in its application to the Committee. The new lawsuit highlights that the application fails to disclose that Hannibal Regional does not presently have a building in which to offer radiation oncology services. The hospital’s application remains pending and is yet to be approved.
The lawsuit also states that Northeast Regional Medical Center in Kirksville, MO, submitted notice to the Committee that it will resume radiation oncology services and install its own linear accelerator with private funds. This creates a situation where there may be no need for two radiation oncology centers in Adair County, further calling into question the necessity of Hannibal Regional Hospital’s project and its appropriation.
This lawsuit also emphasizes the importance of procedural compliance in public health projects funded by taxpayer dollars. The requirement of a certificate of need ensures that any new healthcare services or facilities are justified, necessary, and financially viable before state funds are allocated. By bypassing this requirement, the lawsuit argues, the Missouri legislature acted unlawfully and the Department of Social Services cannot legally make a payment of the funds.
