Florida Certificate of Need Laws
Florida
Mostly Free
Year Enacted
2019
Services Regulated
3
National Rank
14 of 51
Top Systems
- AdventHealth$17B
- HCA Florida
- Orlando Health
Reform Status
Mostly Free with no active reform bill.
Key Case
Sarasota County Hospice Denial
Florida partially repealed its CON laws in 2019, eliminating them for general hospitals. However, CON requirements remain for nursing homes, hospices, and intermediate care facilities, protecting incumbent systems in the post-acute care sector.
3 Services Behind the Gate
- ✓Hospitals
- ✓Nursing Homes / Long-Term Care
- ✓Hospice
The Permission Process
The process for remaining CON services is rigorous. Any 'substantially affected person,' including existing providers, can request an administrative hearing to object to a new competitor's application, creating significant barriers to entry.
This case highlights the core flaw of CON laws: they prioritize the financial stability of existing providers over the benefits of market competition. The state actively defended the incumbent's monopoly, forcing residents to rely on a single provider for end-of-life care.
3 Systems. One Market.
Orlando Area Hospital Market Share (Illustrative)
AdventHealth and Orlando Health are the two dominant players in Central Florida. While hospital CON is gone, their scale gives them immense leverage in the remaining regulated services like hospice and nursing homes.
Sarasota County Hospice Denial
Sarasota County Hospice Denial
Decided 2018 · Sarasota County, Florida · State Court
, Florida Court of Appeals, paraphrasedReform Status: Mostly Free
By repealing most of its CON law, Florida took a significant step toward a more competitive hospital market. However, by leaving protections for nursing homes and hospices, the state continues to shield some of the most profitable sectors from competition.
Florida (Partial Reform)
States With Full Repeal
Data sourced from Cicero Institute, National Academy for State Health Policy (NASHP), Agency for Health Care Administration (AHCA), KFF, and company financial reports.
Last updated: April 2026