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Updated: States with Certificate of Public Advantage (COPA) Laws

In the most recent legislative session, Indiana enacted a new certificate of public advantage (COPA) law (SB 416) that allows mergers of certain hospitals to receive immunity from claims of state antitrust laws for the duration of the certificate. Specifically, hospitals eligible for the COPA must be located in a predominately rural county with a specific population cap and has no more than two hospitals in the statewide comprehensive trauma care system.

Indiana joins 17 other states with existing COPA laws and 1 states with limited COPA laws, mostly enacted since 1993. Five other states, including North Carolina and Montana, have repealed their COPA statutes.

See map below for an overview of existing and repealed COPA laws across the country. Click on the state for citations and to download the statute text available in the SLIHCQ Database.

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