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TennesseeSB 1369114th General Assembly (2025-2026)Senate

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.

Sponsored By: Sponsor information unavailable

Signed by Governor

Health Care

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 2 benefits, 1 costs, 0 mixed.

Acute care hospitals skip need approval

Beginning July 1, 2030, acute care hospitals no longer need a certificate of need to open or operate. This is the state's approval process for whether a facility is needed. The exemption covers hospitals focused on patients with an average stay of 25 days or less. It removes an approval step but does not guarantee that new hospitals open.

New hospital standards support TennCare patients

Beginning July 1, 2030, Tennessee's Health Facilities Commission may adopt added standards for acute care hospitals licensed from that date. Any adopted standards must require TennCare participation and comparable care for TennCare members. They must also require charity care comparable to similar acute care hospitals; the law sets no charity-care amount. By January 1, 2031, the commission must report patient payment sources by area and treatment or procedure. The report must include percentages of TennCare, Medicare, and charity-care patients. The commission must seek input from existing hospitals, physicians, nonprofit hospitals, rural hospitals, investor-owned hospitals, and others. Rulemaking authority took effect when the act became law.

Hospital care sites face tighter rules

Beginning July 1, 2028, satellite emergency departments must be licensed as outpatient departments of Tennessee-licensed hospitals. Facilities providing cardiac catheterization services must also have that hospital outpatient license. Facilities already providing catheterization services on the act's effective date are exempt from that requirement. The law also changes need-based approval rules for inpatient sites away from a hospital's main campus and removes related provisions. The supplied text does not establish whether those inpatient changes make approval easier or harder.

Sponsors & Cosponsors

Sponsors

There is no primary sponsor on record.

Cosponsors

  • Paul Bailey

    Republican • Senate

  • Janice Bowling

    Republican • Senate

  • Rusty Crowe

    Republican • Senate

  • Todd Gardenhire

    Republican • Senate

  • Bobby Harshbarger

    Republican • Senate

  • Tom Hatcher

    Republican • Senate

  • Reeves

    Affiliation unavailable

  • Kerry Roberts

    Republican • Senate

  • Stevens

    Affiliation unavailable

Roll Call Votes

All Roll Calls

Yes: 352 • No: 20

Senate vote • 4/16/2026

FLOOR VOTE: Motion to Concur House Amendment # 9 4/16/2026

Yes: 26 • No: 1

Senate vote • 4/16/2026

FLOOR VOTE: Motion to Concur House Amendment # 8 4/16/2026

Yes: 28 • No: 1

House vote • 4/13/2026

FLOOR VOTE: REGULAR CALENDAR MOTION TO ADOPT AMENDMENT # 8 BY WILLIAMS PASSAGE ON THIRD CONSIDERATION 4/13/2026

Yes: 91 • No: 2

House vote • 4/13/2026

FLOOR VOTE: REGULAR CALENDAR MOTION TO ADOPT AMENDMENT # 9 BY GARRETT PASSAGE ON THIRD CONSIDERATION 4/13/2026

Yes: 88 • No: 1

House vote • 4/13/2026

FLOOR VOTE: REGULAR CALENDAR AS AMENDED PASSAGE ON THIRD CONSIDERATION 4/13/2026

Yes: 84 • No: 11

Senate vote • 3/26/2026

FLOOR VOTE: as Amended Third Consideration 3/26/2026

Yes: 27 • No: 3

Senate vote • 3/18/2026

SENATE HEALTH AND WELFARE COMMITTEE

Yes: 8 • No: 1

Actions Timeline

  1. Effective date(s) 07/01/2030, 07/01/2028, 05/05/2026

    5/18/2026

  2. Pub. Ch. 887

    5/18/2026

  3. Signed by Governor.

    5/5/2026Senate

  4. Transmitted to Governor for action.

    4/23/2026Senate

  5. Signed by H. Speaker

    4/21/2026House

  6. Signed by Senate Speaker

    4/21/2026Senate

  7. Enrolled and ready for signatures

    4/20/2026Senate

  8. Sponsor(s) Added.

    4/17/2026Senate

  9. Concurred, Ayes 28, Nays 1 (Amendment 8 - HA1113)

    4/16/2026Senate

  10. Concurred, Ayes 26, Nays 1 (Amendment 9 - HA1126)

    4/16/2026Senate

  11. Placed on Senate Message Calendar for 4/16/2026

    4/15/2026Senate

  12. Placed on Senate Message Calendar for 4/16/2026

    4/14/2026Senate

  13. Passed H., as am., Ayes 84, Nays 11, PNV 1

    4/13/2026House

  14. Am. withdrawn. (Amendment 7 - HA1073)

    4/13/2026House

  15. Am. withdrawn. (Amendment 6 - HA1071)

    4/13/2026House

  16. Am. withdrawn. (Amendment 4 - HA1049)

    4/13/2026House

  17. Am. withdrawn. (Amendment 3 - HA0893)

    4/13/2026House

  18. H. adopted am. (Amendment 8 - HA1113)

    4/13/2026House

  19. H. adopted am. (Amendment 9 - HA1126)

    4/13/2026House

  20. Am. withdrawn. (Amendment 5 - HA1050)

    4/13/2026House

  21. Am. withdrawn. (Amendment 2 - HA0801)

    4/13/2026House

  22. Am. withdrawn. (Amendment 1 - HA0594)

    4/13/2026House

  23. Subst. for comp. HB.

    4/13/2026House

  24. Rcvd. from S., held on H. desk.

    3/30/2026House

  25. Engrossed; ready for transmission to House

    3/26/2026Senate

Bill Text

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