In recent years, Tennessee legislators have made significant strides in reforming the state’s certificate of need (CON) requirements for establishing new healthcare facilities and services. The CON law historically mandated state approval before entities could initiate or expand certain types of facilities and services. However, on April 23, 2024, lawmakers passed HB 2269, eliminating the need for prior approval for specific services and promoting access to care. Additionally, the law mandates the Health Facilities Commission to conduct a six-year study on the impact of CON reform and facility licensure in the healthcare industry, indicating the possibility of more reforms in the future.
The new legislation affects various services and facility types. The CON requirements for certain facilities have been removed, including new hospital emergency rooms, ambulatory surgical treatment centers, intellectual disability institutional habilitation facilities, MRI and PET services, long-term care hospitals, linear accelerators, and open-heart surgery. These changes will be implemented at staggered effective dates depending on the type of health service.
For instance, as of July 1, 2025, hospitals no longer need CON approval to establish satellite emergency department facilities within 10 miles of their main campus provided they are at least 10 miles away from any licensed acute care hospital or satellite emergency department facility. In subsequent years, the elimination of CON requirements will extend to MRI and PET services on December 1, 2025; ambulatory surgical treatment centers on December 1
