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Tennessee certificate of need reform bill passes House, Senate committees


(The Center Square) – A bill set to begin the process of unwinding and removing many of Tennessee’s certificate of need restrictions for health care services passed both the Senate Health and Welfare Committee and House Health Committee this week.

The bill would first remove CON requirements in counties without an acute care hospital starting July 1, 2025, but begin a 10-mile buffer for competing companies building a new free-standing emergency room.

The bill would then remove burn units, neonatal intensive care, ICF, IDD (intermediate care for disabilities), PET and MRI facilities from CON on Dec. 1, 2025.

The bill removes ambulatory surgical centers, linear accelerators and long-term care hospitals from CON on Dec. 1, 2027 and open-heart surgery centers on Dec. 1, 2029.

The bill came from negotiations after a joint working group studied CON in Tennessee and put forward recommendations.

CON laws were mandated by the federal government in 1972 and regulate how many medical facilities are available in an area and what services they provide in an effort to reduce consumer costs. Even though Congress later eliminated the CON requirement in 1987, many states retained them.

The working group included Sens. Ed Jackson, R-Jackson, Becky Massey, R-Knoxville, Shane Reeve, R-Murfreesboro and Bo Watson, R-Hixson along with Reps. Clark Boyd, R-Lebanon and Ron Gant, R-Piperton.

Boyd sponsored House Bill 2269, which several committee members said they wish went further toward CON repeal.

“I’m going to vote in favor of this legislation although it’s disappointing that this bill does not fully embrace the recommendations of that working group that you explained,” said Rep. David B. Hawk, R-Greeneville. “I’m very frustrated that this bill does not go as far as I believe that it should.”

Hawk named Ballad Health’s monopoly in Northeast Tennessee as an issue impacting residents.

Rep. Tim Hicks, R-Gray, said this is Northeast Tennessee’s largest issue.

Mountain States Health Alliance and Wellmont Health System merged to become Ballad Health in Northeast Tennessee and Southwest Virginia in 2018.

“Instead of trying to put all of this stuff together trying to please everybody, I want to start pleasing the citizens of this state with good health care,” Hicks said. “I think we owe it to them and we need to work hard on it.”

Rep. Aftyn Behn, D-Nashville, said she favors CON reform but believes it is a missed opportunity to expand Medicaid like North Carolina did with a similar bill.