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The Governor of Tennessee recently signed House Bill 2269 into law, creating new exemptions for the state’s certificate of need (CON) process and changing existing CON regulations. Below is a summary of the major legislative changes to Tennessee’s CON process.
Tennessee’s Hospital and ASC Exemptions
The new legislation made a significant change to requirements for freestanding emergency department centers. Starting July 1, 2025, hospitals will no longer be required to obtain a certificate of need for establishing a satellite emergency department facility at a location within ten (10) miles of the hospital’s main campus. However, the satellite emergency department facility must be at least ten (10) miles away from any other actively licensed acute care hospital. This change takes effect on July 1, 2025.
The legislation also removed the requirement for ambulatory surgery centers (ASCs) to obtain a CON, but the bill added new licensing requirements for ASCs. All ASCs must now participate in the TennCare medical assistance program and provide the same amount of care to patients who are TennCare enroll as similarly situated hospital-based ASCs. Additionally, ASCs must now provide an amount of charity care that is comparable to similarly situated hospital-based ambulatory surgical treatment centers. This change takes effect on December 1, 2027.
Additional Tennessee New CON Exemptions
The bill also creates the following new CON exemptions:
- Establishment of a Positron Emission Tomography (PET). Rather than CON review, this requires a provider to show it has been accredited by the American College of Radiology within two (2) years of the date of licensure. (Effective December 1, 2025)
- Initiating Magnetic Resonance Imaging (MRI) services. Rather than CON review, prospective MRI provides must notify the Commission in writing that services are being initiative, and must indicate if MRI will be provided to patients under 14 years old on more than 5 occasions per year. (Effective December 1, 2025)
- The establishment of an intellectual disability institutional habilitation facility, burn unit, and neonatal intensive care units (Effective December 1, 2025)
- Initiation of linear accelerator services (Effective December 1, 2027)
- Initiation of open-heart surgery services (Effective December 1, 2029)
Future Legislation and the Tennessee State Health Plan
The bill mandates the Tennessee Health Facilities commission to create a plan to study the impact of the certificate of need and facility licensure legislation changes on the healthcare industry. This could potentially present further changes to the CON process and regulations.
In March 2024, the Tennessee Department of Health published their 2024-2026 State Health Plan, presenting 58 recommendations to health care providers to meet the needs of Tennesseans and improve the health outcomes of the state. The plan gives potential opportunities for health care providers to develop facilities or services to meet the needs outlined.
RPC provides Certificate of Need (CON) services to healthcare providers nationally. Our experience spans 30 years and about as many states. We work closely with the healthcare provider’s staff to assemble information to address the state’s criteria and requirements. We work to anticipate the arguments that opponents and competing applicants will make in the project design and the supporting documentation.
Link to Tennessee State Health Plan: https://www.tn.gov/health/health-program-areas/state-health-plan.html
View House Bill 2269 Here
Learn More About RPC’s CON Services Here