Committee advances bill to end COPPA and align CON timing in Northeast Tennessee

The Tennessee House Health Committee on a unanimous voice vote advanced HB 2278, a measure that would dismantle the regional Certificate of Public Advantage (COPPA) oversight structure and transfer oversight responsibilities to the attorney general.

Sponsor (Speaker 12) told the committee the bill "simply just removes the COPPA, keeps takes the regulation away from the oversight board and puts the regulation under the attorney general," saying the change is intended to restore competition and avoid government barriers in Northeast Tennessee. He described COPPA as a regulatory structure put in place in 2017 to oversee a large regional health system and said the board-based oversight was originally designed to protect patients while the region adjusted to market changes.

Representative Hill (Speaker 15) offered an amendment to the bill that would dissolve Certificate of Need (CON) requirements for acute care facilities inside the COPPA footprint concurrently with COPPA's repeal. "If we do away with the COPPA, we need to also dissolve the CON requirements ... so that way there's no head start or disparity between eliminating COPPA and introducing competition," Hill said. The committee adopted the amendment by recorded vote (19 ayes, 0 nays).

Members who supported the changes argued the amendment and bill preserve patient protections while removing barriers to entry for new providers. Representative Leary (Speaker 12 in later remarks) clarified for the record that the change shifts oversight rather than eliminating all regulation: oversight would be handled by the attorney general's office, which he said could provide strong enforcement.

Several members asked how the changes would interact with other, statewide CON legislation already moving through the legislature; the sponsor said the bill is limited to the geographic boundaries of the original COPPA and would not affect CON law outside that footprint. After debate and the amendment’s adoption, the committee voted to advance HB 2278 (19 ayes, 0 nays) to the next committee as amended.

Why it matters: The measure alters the post-COPPA regulatory framework for hospital and acute care services in a region of Tennessee that has been governed by a unique, board-based oversight scheme. The amendment’s concurrent dissolution of CON inside that footprint is intended to allow new providers to enter the market at the same time COPPA ends, which supporters say will promote competition and patient choice; critics asked for safeguards to ensure patient protections during the transition.

What’s next: HB 2278 was advanced by the House Health Committee and will proceed through the legislative process with the adopted amendment.