Revolutionizing Healthcare Access: Tennessee’s Certificate of Need Law Reforms and the Future of Facility Licensure

In recent years, Tennessee lawmakers have taken significant steps towards reforming the state’s certificate of need (CON) regulations for establishing new healthcare facilities and services. The CON law historically required state approval before entities could initiate or expand certain types of facilities and services. However, on April 23, 2024, legislators passed HB 2269, which eliminated the need for prior approval for specific services and promoted access to care. Additionally, the law mandated the Health Facilities Commission to conduct a six-year study on the impact of CON reform and facility licensure in the healthcare industry, indicating that more changes may be on the horizon.

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.

Under HB 2269, 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 as long as they are at least 10 miles away from any licensed acute care hospital or satellite emergency department facility. In subsequent years, MRI and PET services will become available without prior approval on December 1st