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Two Hospitals File Applications for Certificate of Public Advantage

Tuesday, February 16, 2016 | 10:38am

Public Given Opportunities to Voice Opinions

NASHVILLE - The Tennessee Department of Health today confirms it has received an application for a Certificate of Public Advantage, or COPA, from both Mountain States Health Alliance and Wellmont Health System. The purpose of Tennessee’s COPA is to protect the interests of the public in the region and the state. To apply for a COPA, the hospitals are required to submit an application with detailed information and data about their proposed merger. This application is a prerequisite to consideration of the granting of a COPA and subsequent active state supervision.

In compliance with state law, TDH Commissioner John Dreyzehner, MD, MPH, will review all submitted COPA application materials. When the application is determined to be complete, a 120-day review period will commence, allowing the department to evaluate possible benefits and disadvantages of a cooperative agreement to merge, including how the proposed changes would affect overall population health in the service area, health care quality and availability and costs of services. The review will also assess any likely adverse impacts from the reduction in competition caused by the proposed merger.

Current state law provides the Tennessee Department of Health with responsibilities to protect the public interest as proposed mergers are presented for consideration. Under Tennessee’s Hospital Cooperation Act of 1993, amended in 2015, the department is charged to review all applications for a COPA to ensure there is “clear and convincing evidence” of benefits, including but not limited to improvements to population health, access to services and economic advantages to the public, and that the inherent reduction in competition to provide health care and related services will not negatively impact the region or state. 

The Tennessee Attorney General will also be reviewing the proposed transaction pursuant to the Public Benefit Hospital Sales and Conveyance Act of 2006, Tenn. Code Ann. §§ 48-68-201, et seq. The COPA will be denied or terminated if the state determines benefits of the agreement fail to clearly and convincingly outweigh any disadvantages attributed to a potential reduction in competition.

All interested stakeholders will have opportunities to provide input in writing, by email or in person on whether the COPA should be issued. Written comments may be submitted to tn.health@tn.gov or Tennessee Department of Health – COPA; 710 James Robertson Parkway; Nashville, TN 37243. Listening sessions will be conducted by a COPA Index Advisory Group, whose members were chosen from the area that will be most affected by the proposed merger. To assure all stakeholders have a voice, the listening sessions will each have different primary areas of focus. 

Dates, times and locations for the public meetings are:

Advisory Group Listening Session #1 For any members of the general public:

Tuesday, March 22, 5:30 p.m. – 7:30 p.m., Carter County Health Department, 403 East G Street, Elizabethton 

Advisory Group Listening Session #2 For internal stakeholders, including employees, contractors, vendors, staff clinicians and others who currently work with Mountain States Health Alliance or Wellmont Health System:

Tuesday, March 29, 5:30 p.m. - 7:30 p.m., Northeast State Regional Performing Arts Center, 2425 TN-75, Blountville

Advisory Group Listening Session #3 For any members of the general public:

Tuesday, April 5, 5:30 p.m. – 7:30 p.m., Holston Electric Cooperative, 1200 West Main Street, Rogersville

Advisory Group Listening Session #4 For external stakeholders, including competing health care providers, non-staff clinicians, payers (including self-insured employers), government agencies and non-profits:

Tuesday, April 19, 5:30 p.m. – 7:30 p.m., Northeast State Regional Performing Arts Center, 2425 TN-75, Blountville

Advisory Group Listening Session #5  For the general public and all stakeholders; during this meeting the Advisory Group will present the proposed COPA index and receive comments:

Tuesday, May 17, 5:30 p.m. – 7:30 p.m., Northeast State Regional Performing Arts Center, 2425 TN-75, Blountville

Tennessee Department of Health Public Hearing For the general public and all stakeholders to provide input on whether the COPA should be issued:

Tuesday, June 7, 5:30 p.m. – 7:30 p.m., Northeast State Regional Performing Arts Center, 2425 TN-75, Blountville

If a COPA is issued, TDH will be responsible for ongoing, active state supervision, according to recently promulgated state rules. This supervision will be informed by a transparent index of measures designed specifically for this COPA that will include measures of population health, access to health services, economic and other factors. All stakeholders will have opportunities to comment on the design of this index. Should a COPA be issued, the results of the index would be publicly reported on a regular basis.

For information about the Advisory Group membership, its working and organizational meetings, the COPA process, or to view the submitted application and other related matters, visit http://tn.gov/health/article/certificate-of-public-advantage.               

Several states have laws providing for Certificates of Public Advantage; these laws have been used infrequently. In Tennessee, there are currently no such active agreements. In addition to TDH and the Tennessee Attorney General having responsibility for state laws, the Federal Trade Commission also has authority to ensure compliance with federal laws.

The mission of the Tennessee Department of Health is to protect, promote and improve the health and prosperity of people in Tennessee. TDH has facilities in all 95 counties and provides direct services for more than one in five Tennesseans annually as well as indirect services for everyone in the state, including emergency response to health threats, licensure of health professionals, regulation of health care facilities and inspection of food service establishments. Learn more about TDH services and programs at www.tn.gov/health