Tennessee bill aims to open more hospitals by ending certificate of need rules

Supporters hope competition will improve care statewide as rural closures leave counties without medical services

Published on Mar. 11, 2026

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A Tennessee bill is moving through the legislature that would dismantle the state's Certificate of Need process, a system that requires companies to prove a community needs a new hospital before they can build or open one. Supporters say the change would allow more hospitals to open, especially in rural areas that have seen closures, while critics worry it could lead to oversaturation and financial challenges for smaller facilities.

Why it matters

The proposed legislation is aimed at addressing the growing problem of rural hospital closures in Tennessee, which have left entire counties without access to medical care. Supporters argue that eliminating the Certificate of Need process will spur competition and improve healthcare access, but opponents are concerned it could destabilize smaller, financially vulnerable hospitals.

The details

The bill would remove cardiac catheterization labs and freestanding emergency rooms from the Certificate of Need process by 2027, and acute care hospitals by 2030. This would allow hospitals to open where they choose, including next to existing facilities, without state oversight. Supporters like House Majority Leader Rep. William Lamberth (R-Portland) say the change will 'decrease wait times, increase competition.' But some hospital administrators, like Scott Tongate of Macon Community Hospital, worry deregulation could 'siphon off' patients from smaller, rural facilities.

  • The bill was debated in a House subcommittee on March 11, 2026, but lawmakers stopped short of voting on it to allow the sponsor to add an amendment.
  • The bill will be considered again next week.

The players

William Lamberth

House Majority Leader (R-Portland) who framed the bill as a step toward improving access and driving down costs.

Raumesh Akbari

Senate Minority Leader (D-Memphis) who expressed hesitation about the bill, pointing to other states that have moved away from Certificate of Need requirements.

Kyle Kopec

Chief Medical Compliance Officer for Braden Health, the company that purchased and reopened the Perry County Community Hospital in Tennessee.

Scott Tongate

Administrator of Macon Community Hospital who raised concerns about what deregulation could mean for smaller, rural facilities.

Braden Health

A company that was able to reopen the Perry County Community Hospital without going through the Certificate of Need process due to a previous legislative exception for counties with no open hospitals.

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What they’re saying

“To go through this application process, you have to spend several hundreds of thousands of dollars. For [Haywood Regional Medical Center], we had to spend around a million dollars. You have to spend a million dollars to ask someone if you can open a hospital.”

— Kyle Kopec, Chief Medical Compliance Officer, Braden Health (newschannel5.com)

“This is just the next logical step to try to decrease wait times, increase competition out there.”

— William Lamberth, House Majority Leader (R-Portland) (newschannel5.com)

“Sumner Regional Medical Center and Hendersonville Medical Center could open up a freestanding ED right in the middle of Lafayette, siphon off probably half of our admissions.”

— Scott Tongate, Administrator, Macon Community Hospital (newschannel5.com)

“I think we've seen states like Texas where they have no Certificate of Need, and it's really the wild wild west of hospitals sprouting up.”

— Raumesh Akbari, Senate Minority Leader (D-Memphis) (newschannel5.com)

“In my experience, competition has never been bad for patients.”

— Kyle Kopec, Chief Medical Compliance Officer, Braden Health (newschannel5.com)

What’s next

The bill will be considered again by the House subcommittee next week after the sponsor adds an amendment.

The takeaway

This proposed legislation highlights the complex tradeoffs between increasing healthcare access and maintaining the financial viability of smaller, rural hospitals. While supporters argue that eliminating the Certificate of Need process will spur competition and improve care, critics warn it could lead to oversaturation and threaten the future of some medical centers that serve vulnerable communities.