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Mississippi Certificate of Need Laws

Certificate of Need Intelligence

Mississippi

90/100

Highly Restrictive

Year Enacted

1979

Services Regulated

7

National Rank

37 of 51

Top Systems

  • University of Mississippi Medical Center
  • Baptist Memorial Health Care
  • Merit Health

Reform Status

States That Reformed

Key Case

No major case law on record.

Mississippi's CON laws have been in place since 1979. They regulate 7 different services, devices, and procedures. For 40 years, the state enforced a moratorium on new home health agencies, a policy so blatantly anti-competitive it took a federal court to strike it down.

01Scope of Regulation

2 Services Behind the Gate

  • Hospitals
  • Home Health Agencies
02The Application Process

The Permission Process

The applicant bears the burden of proving the proposed service is necessary. The process allows for intervention from competitors, who can request administrative hearings to contest the application.

The decision showcases how incumbents can use the CON process to block new competitors from entering a market.

Incumbents retain significant power to block new entrants.

03Market Concentration

3 Systems. One Market.

University of Mississippi Medical Center
Baptist Memorial Health Care
Merit Health

Insurer Dominance

  • Blue Cross Blue Shield of Mississippi
  • Learn about the history and impact of Certificate of Need laws across the United States.

Market share estimated based on available revenue and operational data.

In 2010, St. Dominic's Hospital sought to build a new $121 million hospital in Madison County, one of the fastest-growing and wealthiest counties in the state. The proposed facility would have brought new services and competition to an area dominated by existing providers.

04Case Law & Denials

Blocked, Denied, Upheld

A 40-year moratorium on home health agencies was only lifted by federal court order.

05Legislative Environment

States That Reformed

Mississippi (No Substantive Reform)

States That Reformed

15 states have fully repealed their CON laws.

Studies show repeal leads to more hospitals and ASCs in rural areas.

Data sourced from The Rojas Report proprietary data extraction, state health departments, and public records.

Last updated: April 2026