CMS Ties Rural Health Funding Scores to Repealing CON Laws
The Trump administration is scoring state applications for the $50 billion Rural Health Transformation Program partly on whether states weaken or repeal certificate of need (CON) laws, which require proof of community need before new healthcare facilities can be built or expanded. CMS told states that fewer CON restrictions would improve their funding scores, prompting six states, including Tennessee, Alaska, Connecticut, Delaware, Iowa, and Mississippi, to commit to revisiting their laws. Tennessee has gone furthest, passing a bipartisan bill to unwind most CON rules over four years, while South Carolina separately ended most requirements outside nursing homes. Researchers warn that repealing CON laws removes a key source of transparency into hospital ownership and private equity involvement, since states lose application-driven oversight of facility transactions once the laws disappear.