MSDH Approves Major Updates to State Health Plan and CON Review Manual

The Mississippi State Department of Health (“MSDH”) approved revisions to the State Health Plan and a reorganized Certificate of Need Review Manual at its July 8, 2026, Board of Health meeting, including changes affecting thresholds, exemptions, imaging services, home health, ESRD, and rural hospital projects.

The State Health Plan changes appear to track recent legislation and update several key CON rules. The revisions raise capital expenditure thresholds to $10 million for clinical projects, $20 million for nonclinical projects, and $3 million for major medical equipment. They also add or revise language on UMMC’s “Academic Exemption,” the nursing home and home health moratoria, proton therapy, CT and other imaging services, ESRD facilities, home dialysis equipment, and the Small Community Hospital Pilot Program. MSDH also cleaned up agency names, code citations, and internal references.

The CON Review Manual is a much broader rewrite. Rather than making isolated edits, MSDH appears to have reorganized and rewritten the manual in a new rule-based format. The Manual also includes substantive revisions to key definitions, adds cross-references to the CON Law, and expands rules addressing the scope of CON coverage, application processing, and hearings. It also includes more detailed provisions on project-completion extensions and appeals, as well as new provisions addressing UMMC’s “Academic Exemption” and the Small Community Hospital Pilot Program.

Providers considering new facilities, service lines, imaging equipment, expansions, relocations, ownership changes, or exemption requests should review these changes early, because the revised rules may affect whether a project requires CON approval, whether an exemption is available, and how a CON application is filed and processed.