Regulatory watch
The CON law tracker
Certificate of Need law is moving: roughly 35 states and DC still run a programme, 12 states have fully repealed theirs, and several more are phasing in exemptions or rebuilding their process. This page logs every repeal, reform, threshold change and agency move we track, newest first, each linked to its source. Filing behaviour follows these laws — repeal waves cause filing surges before the door closes.
South Carolina repealed CON for most facility types in 2023. Nursing homes retain CON indefinitely; hospitals require CON only until 1 January 2027. Source
Connecticut disbanded the Office of Health Strategy on 30 June 2026. DPH runs CON "in its current state" until new processes take effect 1 July 2027. New triggers (acquisitions ≥25%, hospital real-estate sales ≥20% of assets), new exemptions, and a $100,000 consultant-fee cap. Source
Illinois fees: $5,000 up to $2.25M project cost, then 0.22% of cost, capped at $150,000 (from 1 July 2025). Review thresholds from 1 July 2026: $18.3M hospitals, $10.4M long-term care, $4.8M other. Source
From 1 December 2025, burn units, neonatal intensive care units and intellectual-disability habilitation facilities no longer need a CON in Tennessee. Source
Urban ambulatory surgical center exemption (counties over 125,000) live since late 2025; MRI and major-equipment exemption in those counties takes effect late 2026. Source
New York raised CON cost thresholds in 2025: hospitals from $15M to $30M; other facilities from $6M to $8M. Source
Nevada moved CON administration to the new Nevada Health Authority effective 1 July 2025. The program applies mainly to counties under 100,000 and geographic-monopoly cases. Source
The U.S. Department of Justice task force (announced February 2025) names healthcare regulation, including state CON laws, among its targets — a tailwind for further repeals. Source
Georgia reformed parts of its CON program in 2024 (HB 1339), adjusting review categories and exemptions. Source
Florida removed hospitals from CON review in 2019. Nursing-home and ICF-DD beds, new facilities and hospice remain under Fla. Stat. 408.036 with four batching cycles per year. Source