AN ACT to amend Tennessee Code Annotated, Title 4; Title 8; Title 56; Title 63 and Title 68, relative to certificates of public advantage.
HB1167 creates a new governance structure for hospital systems that operate under a certificate of public advantage (COPA) in Tennessee. The bill defines a “hospital system” as two or more hospitals or entities party to a cooperative agreement that has received a COPA under existing law, and requires such systems to be governed by a nine-member board of directors. Those directors would be nominated by the governor and generally confirmed by joint resolution of the General Assembly, with staggered initial terms and later three-year terms. The bill also sets rules for vacancies, quorum, attendance, removal, and public meeting access.
The measure would require any existing board that does not comply with the new structure to be vacated and reconstituted within 30 days after the act takes effect, with the new board assuming responsibility on May 1, 2025. If a compliant board is not appointed by that date, the hospital system’s COPA expires. The bill also bars certain conflicted individuals from serving on the board, including employees of participating hospitals, employees of entities doing business with the system, members of participating hospital governing bodies, and persons with a financial interest in affected contracts or transactions. Board meetings must be livestreamed and archived online for public viewing.
HB1167 would amend Tennessee Code Annotated Titles 4, 8, 56, 63, and 68, but its substantive effect is on Title 68’s COPA provisions. It would add a new statutory governance framework for hospital systems operating under a certificate of public advantage, shifting control to a state-appointed board structure and creating a deadline-based enforcement mechanism tied to COPA continuation. The bill would also impose transparency requirements through public internet streaming and archived video, and it would authorize legislative involvement in calling board meetings through a committee of local legislators.
No committee transcripts or recorded votes were provided, so there is no direct evidence of support or opposition from debate or roll call. Based on the text alone, the bill appears to reflect a policy preference for stronger state oversight, public accountability, and conflict-of-interest controls over COPA hospital systems. The inclusion of a hard expiration date for the COPA if a board is not appointed suggests the bill is intended to be forceful and compliance-driven.
The main points of contention likely concern state intervention in private or quasi-private hospital governance, the role of the governor and General Assembly in appointing board members, and the threat that a COPA would expire if the board is not timely constituted. Potentially controversial provisions also include the prohibition on board service by hospital employees, affiliated business partners, and persons with financial interests, as well as the authority given to a committee of local legislators to call board meetings. These features suggest tension between oversight/accountability advocates and those concerned about operational independence, local control, or the stability of hospital system management.