==============================================================================
  CERTIFICATE OF NEED INTELLIGENCE BRIEF: MISSOURI
  The Rojas Report | conlaws.rojasreport.com/states/missouri/
==============================================================================

  State:    Missouri (MO)
  Score:    80/100
  Tier:     Highly Restrictive
  Rank:     33 of 51 jurisdictions

------------------------------------------------------------------------------
  SUMMARY
------------------------------------------------------------------------------

  In-depth analysis of Missouri's Certificate of Need (CON) laws, their
economic impact, and the political landscape surrounding them.

------------------------------------------------------------------------------
  SCOPE OF REGULATION
------------------------------------------------------------------------------
  * Regulated Services
  * Long-term care facilities (nursing homes, assisted living)
  * Psychiatric and rehabilitation services
  * Major medical equipment (MRI, CT, PET scanners)

------------------------------------------------------------------------------
  APPLICATION PROCESS
------------------------------------------------------------------------------

  Missouri's CON law covers a broad range of healthcare services, requiring
providers to obtain state approval for significant capital expenditures. This
includes:

  Missouri Health Facilities Review Committee

------------------------------------------------------------------------------
  MARKET CONCENTRATION
------------------------------------------------------------------------------

  CON laws often lead to consolidated markets, benefiting established players.
In Missouri, the healthcare landscape is dominated by a few large systems,
particularly in the St. Louis metropolitan area.

  $81.4B in discounted drugs. Zero disclosure requirements.

------------------------------------------------------------------------------
  REFORM STATUS
------------------------------------------------------------------------------

  Partial Repeal Pending

------------------------------------------------------------------------------
  CASE LAW / DENIALS
------------------------------------------------------------------------------

  In a clear example of bureaucratic hurdles, the Missouri Health Facilities
Review Committee unanimously denied a CON for an 18-bed residential care
facility. The denial was not based on need, but on a technicality: the
applicant had moved the proposed site by 1.5 miles after filing the initial
letter of intent. This case highlights how CON regulations can stifle
development over procedural minutiae rather than community benefit.

==============================================================================
  Source: The Rojas Report | conlaws.rojasreport.com/states/missouri/
  Data: Cicero Institute, NASHP, FTC, DOJ, CMS, state health departments
  Generated: April 2026
==============================================================================