Hospitals can now spend twice as much before asking the state’s permission

Mississippi makes hospitals, nursing homes and clinics get a certificate of need before building, adding services or buying big equipment. A certificate of need is a state permit that says the project is needed; the Department of Health grants or denies it, and competitors can object. The law doubles the spending thresholds that trigger the permit: for clinical improvements other than major medical equipment, from $5 million to $10 million, Mississippi Today reported. Major medical equipment now needs a permit above $3 million, according to the bill summary the Wire read.

It narrows the University of Mississippi Medical Center’s exemption. UMMC did not need a permit for facilities or equipment used for education; now that exemption is limited to the area around UMMC’s main campus and the Jackson Medical Mall, Mississippi Today reported. If UMMC seeks to make a capital improvement or open a new facility outside the Jackson area, the Department of Health must determine that the expense fulfills a ‘substantial and meaningful academic function,’ SuperTalk reported from the bill text. The HB 1622 summary the Wire read puts that finding inside a defined area of Jackson instead, and lets existing facilities keep the exemption as long as they are not moved; the Wire could not settle the difference.

The Department of Health must also study whether small hospitals should be exempt for dialysis units and geriatric psychiatric units.

A similar bill reached Gov. Tate Reeves in 2025 and he vetoed it over a provision tied to a legal dispute between Texas-based Oceans Healthcare and St. Dominic Hospital, SuperTalk reported. This year’s bill removed the provision that led to the veto, Mississippi Today reported.

A federal court ruled in January 2026 that the state’s decades-long moratorium was unconstitutional, the law firm Bradley wrote in its session recap; a moratorium is a freeze on permits for new health care facilities. The reforms came on the heels of that ruling, Bradley wrote.

Rep. Sam Creekmore, the New Albany Republican who chairs the House Public Health and Human Services Committee, wrote the bill, and it passed both chambers unanimously, SuperTalk reported. State Health Officer Dr. Dan Edney told SuperTalk that having to get a permit to spend money over a threshold is, ‘in my opinion, ridiculous.’ The Board of Health and the health department had recommended eliminating the thresholds, he said, but ‘they chose to double them, which is a good move.’

The UMMC limit is about competition: the bill seeks to level the playing field between UMMC and other health care providers, Mississippi Today reported. Critics of certificate-of-need laws argue they stifle competition and fail to lower costs; advocates say they ensure communities have access to a range of services, not only the profitable ones, Mississippi Today reported. With more than half of Mississippi’s rural hospitals at risk of closing, some argue the laws keep struggling hospitals from opening profitable services, the report said.

The Wire could not find a state cost estimate, a fee schedule or an estimate of what hospitals will save. The Wire’s read: a project that falls between the old threshold and the new one no longer goes through the state’s review, and the time that saves is the point of the law.

Whether patients pay less is the open question. Stakeholders are divided on whether the permit law lowers costs, Mississippi Today reported.

The Wire’s read: hospitals may renovate, add imaging and expand units faster, because fewer projects go through the permit process and the objections that come with it.

If you use UMMC’s clinics outside the Jackson area, a new one will need the Department of Health to find that it serves a meaningful academic function, SuperTalk reported.

The law draws a line around UMMC’s home turf: the area around its main campus and the Jackson Medical Mall, Mississippi Today reported. The HB 1622 summary says UMMC can also plan and build clinical research units in Jackson without a permit.

The Department of Health’s feasibility study on exempting small hospitals’ dialysis and geriatric psychiatric units. The Wire could not find a due date in its sources.

HB 1622, signed March 23, 2026, goes further for rural hospitals: a Small Community Hospital Pilot that lets hospitals in counties with no town over 15,000 people add services without a permit, with an application deadline of June 30, 2027. The Wire will explain it separately.