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  CERTIFICATE OF NEED INTELLIGENCE BRIEF: RHODE ISLAND
  The Rojas Report | conlaws.rojasreport.com/states/rhode-island/
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  State:    Rhode Island (RI)
  Score:    80/100
  Tier:     Highly Restrictive
  Rank:     33 of 51 jurisdictions

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  SUMMARY
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  Rhode Island CON score 80/100 (highly restrictive). 18 services regulated
since 1970. Lifespan and Care New England control ~80% of acute-care beds.

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  SCOPE OF REGULATION
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  * Regulated Services
  * Hospitals & Nursing Homes
  * Home Care & Hospice Agencies
  * Bed Expansions (>10 beds or 10%)
  * PET, MRI, and Linear Accelerators

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  APPLICATION PROCESS
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  Rhode Island's long-standing and expansive Certificate of Need program
creates significant barriers to entry, protecting incumbent health systems and
limiting consumer choice. The state's healthcare market is highly
concentrated, with a few dominant players.

  The Application Gauntlet

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  MARKET CONCENTRATION
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  Rhode Island's long-standing and expansive Certificate of Need program
creates significant barriers to entry, protecting incumbent health systems and
limiting consumer choice. The state's healthcare market is highly
concentrated, with a few dominant players.

  New services with >$1.7M annual operating cost

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  CASE LAW / DENIALS
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  Case Study: Encompass Health Denied

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