At its July meeting held last week, the Massachusetts Public Health Council approved revisions to the Determination of Need guidelines for radiation therapy, finding need for an additional eight units. This finding is based on population growth since the guidelines were last revisited, about seven years ago, and projected further growth. The guidelines permit hospitals to expand existing radiation therapy programs outside of the eight-unit cap. While one may debate whether there is a place for certificate of need (or, as we call it here in Massachusetts, determination of need) in today’s health care economy, the political reality is that it is not going away anytime soon. Applications for radiation therapy projects may be filed on a special filing date of October 1, 2006.