Oregon Certificate of Need Laws
Oregon
Restrictive
Year Enacted
—
Services Regulated
—
National Rank
27 of 51
Top Systems
- Providence Health Oregon
- Legacy Health
Market Concentration
(HHI equivalent)
Reform Status
Restrictive with no active reform bill.
Key Case
Case File: NEWCO Oregon, Inc.
An in-depth look at the state's Certificate of Need landscape.
4 Services Held Hostage
- ✓Hospitals
- ✓Ambulatory Surgery Centers (ASCs)
- ✓Nursing Homes / Long-Term Care
- ✓Psychiatric Facilities
The Permission Process
exemption of Ambulatory Surgical Centers (ASCs) from CON review in 2009
However, the core of the law, which covers new hospitals and long-term care facilities, remains firmly in place, preserving the gatekeeping power of the state and incumbent systems.
The Oregon Healthcare Cartel
Insurer Dominance
- Largest Insurers
- 1. Kaiser Foundation:
- 2. Regence BCBS:
- Explore our comprehensive overview of Certificate of Need laws across the United States.
The state's score of 65 reflects this mixed reality: a major reform in the past, but a system that still significantly restricts market entry for core healthcare facilities.
$81.4B in discounted drugs. Zero disclosure requirements.
Case File: NEWCO Oregon, Inc.
Case File: NEWCO Oregon, Inc.
Psychiatric Hospital Denied
In 2017, the Oregon Health Authority denied a Certificate of Need for a proposed 100-bed freestanding psychiatric hospital in Wilsonville. The applicant, NEWCO, argued the state desperately needed more mental health capacity.
OHA concluded the project failed to meet multiple criteria, including need and cost-effectiveness, despite acknowledging the applicant's financial soundness. The denial sparked public controversy, with NEWCO framing it as an anticompetitive blockade by the state that ultimately harmed patients in need of care.
Data sourced from state agencies, Cicero Institute, and public records.
Last updated: April 2026