TBA Law Blog


Posted by: Azya Thornton on Apr 6, 2026

The U.S. Federal Trade Commission (FTC) has warned Tennessee state lawmakers that ending Ballad Health’s state-approved hospital monopoly without immediate competition could raise health care costs. The legislation in question would end Ballad’s Certificate of Public Advantage (COPA) agreement in 2028, lifting restrictions on the 20-hospital chain in Tennessee and Virginia. A second bill would eliminate a law allowing hospitals to block competitors through a Certificate of Need (CON) process in 2030, the Tennessee Lookout reports. The FTC said the two-year gap could “undermine” the lawmakers’ goal of increasing competition. The monopoly, created in 2018, has faced scrutiny for failing to meet benchmarks on infection rates, mortality, emergency room wait times, and patient satisfaction. FTC officials said the proposed timeline could be the “worst possible outcome for patients” by limiting oversight while still restricting competition. Ballad Health officials said they will defer to lawmakers on future policy decisions.