Tennessee House Bill HB0819

Tennessee 2025-2026 Regular Session

• Introduced: 2/4/25
• Refer: 2/6/25
• Refer: 3/26/25
• Refer: 3/3/26
• Refer: 3/18/26
• Refer: 3/24/26

Caption

AN ACT to amend Tennessee Code Annotated, Title 4; Title 33; Title 68; Title 71 and Chapter 985 of the Public Acts of 2024, relative to certificates of need.

Summary

HB0819 amends Tennessee’s certificate-of-need laws to create a new exemption for “acute care hospitals.” The bill defines an acute care hospital as a hospital whose primary focus is patients with an average length of stay of 25 days or less, and states that this part of the law does not require a certificate of need to establish or operate such a facility. In effect, the bill would allow certain short-stay hospitals to open and operate without going through Tennessee’s certificate-of-need review process. The measure also amends Chapter 985 of the Public Acts of 2024 and includes delayed effective dates for different sections of the broader act, with the new acute care hospital provisions taking effect July 1, 2028. The bill is framed as part of a larger package of changes to Tennessee Code Annotated across multiple titles, but its most direct policy change is the new exemption from CON requirements for acute care hospitals.

Impact

The bill would change Tennessee’s health facility licensing and planning framework by carving acute care hospitals out of the certificate-of-need regime. That would affect hospital developers, existing hospital systems, regulators, and communities where new facilities may be proposed, because a facility meeting the definition could be established without CON approval. It would also modify Tennessee Code Annotated Section 68-11-1602 and Section 68-11-1607, and it amends a recent public act from 2024 to incorporate the new exemption and timing provisions.

Sentiment

The committee voting history suggests generally favorable support for the bill, with strong majorities in the House Health Committee and House Finance, Ways, and Means Committee and unanimous support in the Finance subcommittee. The repeated “pass if amended” recommendations indicate that members were broadly supportive of the policy direction but wanted changes before final advancement. No committee transcripts were provided, so the available record shows support through votes rather than detailed debate.

Contention

The main point of contention appears to be the policy choice to exempt acute care hospitals from certificate-of-need review, which can be controversial because CON laws are often defended as a way to control costs, prevent overbuilding, and protect access, while opponents argue they restrict competition and delay needed care. The “pass if amended” votes suggest there were unresolved technical or policy concerns, likely around the scope of the exemption, the definition of acute care hospital, or how the change would interact with existing hospital regulation. The close-but-positive committee margins in some votes also indicate some resistance, though not enough to stop the bill from moving forward.