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HB 819

Health Care - As introduced, removes acute care hospitals from the requirement of obtaining a certificate of need beginning July 1, 2028. - Amends TCA Title 4; Title 33; Title 68; Title 71 and Chapter 985 of the Public Acts of 2024.

114th Regular Session (2025-2026) Introduced by Johnny Garrett

Tennessee removes hospital certificate of need requirements starting July 2028, allowing acute care facilities to expand without state regulatory approval, potentially increasing competition but risking market imbalance.

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Bill Summary · HB 819

Legislative bill overview

HB 819 eliminates the certificate of need (CON) requirement for acute care hospitals in Tennessee, effective July 1, 2028. This removes state-level approval processes that hospitals currently must complete before establishing new facilities or expanding services. The bill amends multiple Tennessee Code Annotated sections and a 2024 public act to facilitate this deregulation.

Why is this important

Certificate of need laws regulate healthcare facility expansion to control costs and prevent duplicative services, but critics argue they limit competition and patient access. Removing this requirement could accelerate hospital expansion and new facility construction, potentially lowering barriers to entry for healthcare providers while eliminating a layer of state oversight. This represents a significant shift in Tennessee's healthcare regulatory framework.

Potential points of contention

  • Market saturation concerns: Without CON requirements, some regions could see overbuild of hospital capacity while rural or underserved areas remain neglected, as providers follow profit incentives rather than need-based planning
  • Healthcare cost implications: CON proponents argue elimination could increase healthcare costs through redundant services and infrastructure; opponents argue competition will drive prices down
  • Rural hospital impact: Smaller, rural hospitals may face increased competition from larger health systems without CON protections, potentially threatening their viability and access in remote areas

Compiled from official sources — confirm details with the bill’s official record.

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