Louisiana Certificate of Need Laws
Louisiana
Restrictive
Year Enacted
—
Services Regulated
—
National Rank
25 of 51
Top Systems
- Ochsner Health
- LCMC Health
Reform Status
Restrictive with no active reform bill.
Key Case
Blocked: Sivad Home and Community Services
Louisiana's Facility Need Review (FNR) process is narrower than traditional CON laws and primarily targets specific provider types, many linked to Medicaid reimbursement.
4 Services Held Hostage
- ✓Hospitals
- ✓Nursing Homes / Long-Term Care
- ✓Hospice
- ✓Substance Abuse Treatment
The Permission Process
The process is managed by the Louisiana Department of Health (LDH) and is primarily a paper review.
While reforms in 2022 and 2024 have clarified the FNR process, they have also entrenched it by formalizing committee structures and even expanding its reach to new provider types like residential substance abuse treatment. The system lacks a general capital expenditure threshold, meaning it doesn't block major hospital expansions, but it remains a significant barrier to entry for smaller, specialized providers in the covered categories.
The Louisiana Healthcare Cartel
Insurer Dominance
- Top Insurers by Market Share
- UnitedHealth Group
- BCBS of Louisiana
- Humana Group
Louisiana's hospital market is dominated by a few large, non-profit systems that wield significant market power, particularly in metro areas like New Orleans and Baton Rouge.
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Blocked: Sivad Home and Community Services
Blocked: Sivad Home and Community Services
Data sourced from state agencies, Cicero Institute, and public records.
Last updated: April 2026