Tennessee Lawmakers Take the Reins: Eliminating Certificate of Need Requirements and Promoting Health Care Access

Tennessee legislators have recently been working to reform the certificate of need (CON) requirements for establishing new health care facilities and services in the state. Historically, Tennessee’s CON law mandated approval by the state before entities could initiate or expand specific types of facilities and services, leading to a long list of restrictions. However, on April 23, 2024, lawmakers passed legislation (HB 2269) that eliminated the need for the state’s prior approval for certain services and aimed to improve access to care.

The new law also mandates the Health Facilities Commission to conduct a six-year plan of study on the impact of CON reform and facilities licensure in the health care industry, signaling the potential for further reforms in the future. The changes outlined in the legislation will take effect at different times, depending on the type of health service. For example, as of July 1, 2025, hospitals will no longer require a CON to establish satellite emergency department facilities within 10 miles of the main campus, provided they are at least 10 miles away from any actively licensed acute care hospital or satellite emergency department facility. Similarly, as of December 1, 2025, CON requirements for MRI or PET services will be eliminated, and a license from the Health Facilities Commission will suffice to establish or conduct such services. Proof of accreditation by the American College of Radiology will be necessary for establishing or conducting PET services. Additional changes include removing CON requirements for ambulatory surgical treatment centers and linear accelerator procedures on later dates.

The types of health services impacted by these changes include new hospital emergency rooms, ambulatory surgical treatment centers, intellectual disability institutional habilitation facilities, MRI and PET services