Certificate of Need (CON) is a state regulation requiring health practitioners to obtain prior approval from state regulators before offering certain medical equipment, such as MRIs and CT scanners, for use by patients. Certificate of Need laws still in place in thirty-five states, which require healthcare facilities to get permission from a government commission to expand or otherwise invest in additional medical equipment. These commissions are often stacked with representatives from existing hospitals, who have an incentive to restrict new supply and thus limit competition.
During the 2019-2020 COVID-19 outbreak, CON laws became the subject of controversy due to their creating an unnecessary shortage of hospital beds. According to the Mises Institute, "CON laws are one of countless government interventions limiting the supply of medical care in the US." In response, several states moved to circumvent CON laws including Georgia, Tennessee, Iowa, Vermont, and Alabama. 
Below is an unverified list of states that do and do not require a Certificate of Need as of 2005. Check with an attorney on the current law in your state.
Also, the District of Columbia requires a Certificate of Need
States not requiring a Certificate of Need (as of 2005)Edit
- How the Left Is Trying to Blame Capitalism for COVID-19 Deaths, Bradley Thomas, misis.org
- Competition in Health Care and Certificates of Need, "Many CON programs trace their origin to a repealed federal mandate, the National Health Planning and Resources Development Act of 1974, which offered incentives for states to implement CON programs."
- See also crony capitalism
- America's hospitals are unprepared for coronavirus — here's why you should blame government
- How the Left Is Trying to Blame Capitalism for COVID-19 Deaths
- Gov. Reynolds issues State of Public Health Disaster Emergency
- State of Tennessee Executive Order
- Kemp Backs Bid For Certificate-Of-Need Changes, Gets House Panel OK On Waiver Plan
- Certificate of Need Bulletin 002
- Proclamation by the Governor
- Map and list as of September 2007 of Certificate of Need states
- detailed list of state-by-state requirements as of 2003