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Certificate of Public Advantage

Through the passage of Senate Enrolled Act (SEA) 246 in 2021 and with subsequent amendments in SEA 298 (2022), the Indiana General Assembly provided the statutory authority for the Indiana Department of Health (the department) to issue a Certificate of Public Advantage (COPA or certificate) for certain hospital mergers. A certificate would require the regulation of merged hospital system by the department in place of regulation by the Federal Trade Commission through anti-trust laws. Under Indiana Code 16-21-15, the department can issue a certificate only if it finds that there is clear evidence that the proposed merger would improve the health outcomes, healthcare access, and the quality of healthcare provided to the population currently served by the hospitals, and those benefits must outweigh any potential disadvantages that result from the proposed merger.

Under current law, only hospitals that meet the following requirements may submit an application by July 1, 2026.

The hospitals are located in a county that meets the following criteria:

(1) Has a population that is less than one hundred forty thousand (140,000) and is not contiguous to a county with a population of more than two hundred fifty thousand (250,000).
(2) Has only two (2) hospitals that are both in the statewide comprehensive trauma care system under IC 16-19-3-28 and one (1) of the hospitals is a teaching hospital with a medical residency program.
(3) Is a predominately rural county.

Currently Eligible Counties: Vigo County