Certificate of Public Advantage (COPA)

  • A Certificate of Public Advantage (COPA) is the written approval by the Tennessee Department of Health (TDH) that governs a Cooperative Agreement (a merger) among two or more hospitals. A COPA provides state action immunity to the hospitals from state and federal antitrust laws by replacing competition with state regulation and Active Supervision. The goal of the COPA process is to protect the interests of the public in the region affected and the State.
  • TDH has the authority to issue a COPA if applicants pursuing a COPA demonstrate that the likely benefits of the proposed Cooperative Agreement outweigh the likely disadvantages that would result from the loss of competition. The ability to grant a COPA is authorized by Tennessee’s Hospital Cooperation Act of 1993, amended in 2015. Permanent Rules 1200-38-01 implement T.C.A. § 68-11-1301 – 68-11-1309.
  • Tennessee Department of Health Commissioner John Dreyzehner, MD, MPH, announced January 31, 2018 that the state is officially allowing a merger of Wellmont Health System and Mountain States Health Alliance by issuing a Certificate of Public Advantage or COPA to their parent company, Ballad Health.​
  • Fourth Amended and Restated Terms of Certification, dated July 1, 2023
  • Certificate of Public Advantage