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Montana Certificate of Need Laws

Certificate of Need Intelligence

Montana

5/100

Mostly Free

Year Enacted

Services Regulated

National Rank

14 of 51

Top Systems

  • Billings Clinic

Reform Status

1975 (Mostly Repealed)

Key Case

No major case law on record.

Dept. of Public Health and Human Services

01Scope of Regulation

5 Services Held Hostage

  • Hospitals
  • Ambulatory Surgery Centers (ASCs)
  • Nursing Homes / Long-Term Care
  • Home Health Agencies
  • Imaging (MRI, CT, PET)
02The Application Process

The Permission Process

The process for the remaining CON is administered by the DPHHS, but its narrow focus means few applications are filed.

03Market Concentration

The Montana Healthcare Cartel

Billings Clinic
05Legislative Environment

1975 (Mostly Repealed)

1975 (Mostly Repealed)

Billings Clinic, Providence Health

Current Law (Post-Repeal)

Montana stands as a success story for CON repeal. By eliminating the certificate of need requirement for hospitals, ASCs, and other critical access points, the state has prioritized market competition and provider autonomy. The only remaining vestige is the requirement for long-term care facilities.

Previous Law (Pre-Repeal)

Originally enacted in 1975, Montana's former CON program was broader, covering a wider range of healthcare facilities and services. The decision to repeal these provisions reflects a legislative shift towards free-market principles in healthcare, recognizing that such laws often stifle innovation and access.

Understanding CON Repeal

Another state that has successfully repealed most of its CON program.

Data sourced from state agencies, Cicero Institute, and public records.

Last updated: April 2026