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AßÐ ‘á  Ðó óÌÓ  ÓThis€is€a€declaratory€judgment€action€wherein€a€private€act€hospital€authority,€established€pursuantÐ ŒÜ Ðto€Tennessee€Code€Annotated€sections€7„57„601€to€604,òòóó€seeks€a€declaration€that€it€has€the€authorityÐ xÈ Ðto€enter€into€an€exclusive€contract€for€professional€radiology€services,€thus€limiting€the€use€ofÐ d´ Ðimaging€equipment€and€hospital€support€staff€situated€in€the€hospital€to€such€exclusive€providers€ofÐ P  Ðradiology€services.€€Defendants€are€four€competent€radiologists,€presently€on€the€medical€staff€of€theÐ <Œ Ðhospital,€who€have€also€established€Premier€Diagnostic€Imaging€Center,€LLC€to€provide€outpatientÐ (x Ðradiology€services€independent€of€the€hospital.€€The€exclusive€contract€sought€by€the€hospital€wouldÐ d Ðeffectively€ð ðcloseðð€use€of€the€hospital€imaging€facilities€and€support€staff€to€all€radiologists€exceptÐ P Ðthe€providers€named€in€the€exclusive€contract.€€The€trial€court€declared€that€the€hospital€wasÐ ì< Ðauthorized€to€enter€into€such€an€exclusive€provider€contract,€and€we€affirm€the€judgment€of€the€trialÐ Ø( Ðcourt.Ð Ä ÐÓÓÌò òTenn.€R.€App.€P.€3€Appeal€as€of€Right;€Judgment€of€the€Chancery€Court€Affirmedó óÐ œì ÐÌòòÓ  ÓÔ#†¼D5»àXQÈ#ÔÔ‡XQX.¼D5ÔWilliam€B.€Cain,óó€J.,€delivered€the€opinion€of€the€court,€in€which€òòóóBòòEN€óóH.€Ô_ÔCòòANTRELLÔ_Ôóó,€Ô_ÔP.J.Ô_Ô,€andÐ t Ä ÐòòóóRòòOBERT€óóL.€JòòONESóó,€SòòPóó.€J.,€joined.Ð `!°  ÐÌWilliam€H.€West,€Nashville,€Tennessee€and€John€Ô_ÔAcuffÔ_Ô,€Ô_ÔCookevilleÔ_Ô,€Tennessee,€for€the€appellants,Ð 8#ˆ" ÐWilliam€M.€Humphrey,€M.D.,€John€P.€Ô_ÔLimbacherÔ_Ô,€M.D.,€Daniel€F.€Ô_ÔCoonceÔ_Ô,€M.D.,€George€O.€Mead,Ð $$t# ÐM.D.,€and€Putnam€Radiology,€P.C.Ð %` $ ÐÌAndree€Sophia€Ô_ÔBlumsteinÔ_Ô,€Nashville,€Tennessee,€for€the€appellees,€City€of€Ô_ÔCookevilleÔ_Ô,€Tennessee,Ð è&8"& Ðby€and€through€Ô_ÔCookevilleÔ_Ô€Regional€Medical€Center,€and€Ô_ÔCookevilleÔ_Ô€Regional€Medical€CenterÐ Ô'$#' ÐAuthority.Ð À($( ÐÌWilliam€B.€Ô_ÔHubbardÔ_Ô,€Nashville,€Tennessee,€for€amicus€curiae,€Tennessee€Hospital€Association.Ð ˜*è%* ÐAndrew€Ô_ÔYarnellÔ_Ô€Ô_ÔBeattyÔ_Ô,€Nashville,€Tennessee,€for€amicus€curiae,€Tennessee€Medical€Association.Ð „+Ô&+ ÐDavid€L.€Steed,€Nashville,€Tennessee,€for€amicus€curiae,€Medical€Staff€of€Ô_ÔCookevilleÔ_Ô€RegionalÐ p,À', ÐMedical€Center.€Ð \-¬(-ý ÐÔ_ ÔÓq Óò òOPINIONó óÔ#†¼D5»XXQ  #ÔÔ‡XQX»¼D5ÔÐ ° ÐÌòòóóÔ#†¼D5»XXQ@#ÔÓ  ÓÔ€XQX»¼D5Ôà  àThe€facts€necessary€to€a€decision€in€this€case€were€stipulated€by€the€parties,€and€the€case€wasÐ ˆØ Ðsubmitted€to€the€trial€court€on€cross€motions€for€summary€judgment.€€The€trial€court€granted€theÐ tÄ ÐMotion€for€Summary€Judgment€filed€by€Plaintiff€hospital,€and€Defendant€radiologists€appeal.Ð `° ÐÌà  àCookeville€Regional€Medical€Center€(ð ðCRMCðð)€is€a€private€act€public€hospital€operated€byÐ 8 ˆ Ðthe€City€of€Cookeville,€by€and€through€Cookeville€Regional€Medical€Center€Authority€(ð ðCRMCAðð).€Ð $ t ÐThis€hospital€is€established€under€the€provisions€of€Tennessee€Code€Annotated€sections€7„57„601Ð  ` Ðto€604.òòóó€€Defendants,€Drs.€Humphrey,€Limbacher,€Coonce,€and€Mead€form€a€professional€corporationÐ ü L  Ðknown€as€Putnam€Radiology,€P.C.€and€are€competent€and€qualified€radiologists€with€staffÐ è 8  Ðmembership€and€clinical€privileges€at€CRMC.€€They€practice€at€CRMC€Imaging€Department,€whichÐ Ô$  Ðhas€historically€operated€as€an€open€staff€department€without€an€exclusive€provider€contract.€€Ð À  ÐÌà  àDefendant€radiologists,€in€early€1999,€also€formed€a€limited€liability€company,€PremierÐ ˜è  ÐDiagnostic€Imaging€Center,€LCC,€and€applied€for€a€Certificate€of€Need€for€an€outpatient€diagnosticÐ „Ô  Ðcenter€in€which€they€intended€to€provide€outpatient€imaging€services€in€competition€with€CRMC.€Ð pÀ ÐThe€Certificate€of€Need€was€granted€to€Premier€Diagnostic€Imaging€Center,€LCC€on€April€28,€1999.€Ð \¬ Ðà  àAt€a€March€25,€1999€meeting,€the€CRMCA€Board€of€Trustees€decided€to€ð ðcloseðð€the€medicalÐ H˜ Ðstaff€of€the€Imaging€Department€at€CRMC€by€seeking€an€exclusive€provider€€contract€for€in€hospitalÐ 4„ Ðimaging€services.€€The€result€of€such€a€contract€would€be€that€only€radiologists€employed€by€theÐ  p Ðexclusive€provider€under€the€contract€would€have€access€to€and€use€of€the€imaging€facilities€andÐ  \ Ðsupport€staff€at€CRMC.€Ð øH ÐÌà  àThe€medical€staff€of€CRMC€voted€to€support€the€Defendant€radiologists€and€theirÐ Ð  Ðprofessional€corporation,€Putnam€Radiology,€PC,€in€becoming€the€providers€of€radiology€servicesÐ ¼  Ðunder€such€an€exclusive€contract€if€an€agreement€could€be€reached€on€such€a€contract.€€On€April€19,Ð ¨ø Ð1999,€CRMC€issued€a€request€for€a€proposal€from€qualified€radiology€groups€to€operate€andÐ ”ä Ðadminister€its€Imaging€Department€under€an€exclusive€contract.€€Putnam€Radiology,€PC€objected€toÐ €Ð Ðseveral€provisions€in€the€proposed€exclusive€contract€including€the€ð ðreasonable€non„competeÐ l¼ Ðprovisionsðð€and€a€provision€for€termination€of€medical€staff€privileges€immediately€upon€theÐ X ¨ Ðtermination€of€the€radiology€services€contract.€€In€the€words€of€Dr.€Humphrey:€€ð ðà8 @Ô àIt€is€our€position€thatÐ D!” Ðthe€medical€staff€bylaws€of€CRMC€do€not€give€the€hospital€the€power€to€exclude€radiologists€on€itsÐ 0"€  Ðstaff€from€access€to€the€devices€and€staff€of€the€hospital.ððÐ #l! ÐÌà  àAn€impasse€having€thus€been€reached€as€to€any€exclusive€services€contract€between€CRMCÐ ô$D # Ðand€Putnam€Radiology,€PC,€the€exclusive€provider€contract€proposal€was€put€on€hold,€and€the€CityÐ à%0!$ Ðof€Cookeville,€by€and€through€CRMC€and€CRMCA,€on€July€1,€1999,€filed€this€action€for€declaratoryÐ Ì&"% Ðjudgment€seeking€a€declaration€of€the€right€to€close€the€Imaging€Department€at€CRMC€by€means€ofÐ ¸'#& Ðan€exclusive€provider€contract.€€On€July€29,€1999,€the€Defendants€answered€the€Complaint€and€filedÐ ¤(ô#' Ða€Counterclaim€asserting€that€the€medical€staff€bylaws€of€CRMC€had€been€violated€by€the€actionsÐ )à$( Ðâ âof€Plaintiff€and€that€the€decision€to€close€the€CRMC€Imaging€Department€was€done€in€retributionÐ |*Ì%) Ðagainst€Defendants€for€their€actions€in€obtaining€a€Certificate€of€Need€for€the€establishment€of€anÐ ° Ðoutpatient€diagnostic€imaging€center€in€Cookeville.Ð œì Ðâ âÌà  àThe€case€was€heard€by€Chancellor€Billy€Joe€White€on€January€17,€2001€on€cross€motions€forÐ tÄ Ðsummary€judgment€filed€by€the€parties.€€The€Chancellor€granted€Plaintiffsðð€Motion€for€SummaryÐ `° ÐJudgment€by€Order€of€February€12,€2001€holding:Ð L œ ÐÌà8  àà ` àThe€Court€finds€that€the€Tennessee€Private€Act€Hospital€Authority€Act€ofÐ $ t Ð1996,€Tenn.€Code€Ann.€ðð€7„57„601€òòet€seq.óó,€gives€the€Plaintiff€Cookeville€RegionalÐ  ` ÐMedical€Center€Authority€(the€ð ðHospitalðð)€the€authority€to€close€a€HospitalÐ ü L  Ðdepartment€for€competitive€and€economic€reasons€through€an€exclusive€contractingÐ è 8  Ðarrangement€even€though€doing€so€will,€in€this€case,€incidentally€affect€theÐ Ô$  ÐDefendantsðð€staff€privileges.€€The€Hospital€has€the€right€to€close€the€staff€of€itsÐ À  ÐImaging€Department€and€to€seek€an€exclusive€provider€of€radiology€services,€and€theÐ ¬ü  ÐDefendantsðð€loss€of€their€staff€privileges€necessarily€follows.€€The€Court€finds€thatÐ ˜è  Ðthere€is€no€issue€concerning€the€competence€of€the€Defendant€radiologists€and€that,Ð „Ô  Ðtherefore,€it€would€be€meaningless€to€require€the€Hospital€to€provide€a€hearingÐ pÀ Ðregarding€any€adverse€effect€on€privileges.€€The€Court€finds€that€the€PlaintiffsððÐ \¬ Ðdecision€to€close€the€Hospitalððs€Imaging€Department€is€a€business€decision.ÐH˜Ð Ð  ÐÌà8  àà ` àThe€Court€further€finds€that:€€the€Hospitalððs€Medical€Staff€Bylaws,€andÐ  p Ðspecifically€Section€14.1.D€of€the€Medical€Staff€Bylaws,€do€not€give€the€MedicalÐ  \ ÐStaff€the€right€to€veto€a€decision€by€the€Hospital€to€close€a€previously€openÐ øH Ðdepartment;€Section€14.1.D€gives€the€Medical€Staff€only€the€right€to€makeÐ ä4 Ðrecommendations€to€the€Hospital€Board;€there€is€no€breach€of€the€Medical€StaffÐ Ð  ÐBylaws;€and€there€are€no€due€process€problems€in€connection€with€the€HospitalððsÐ ¼  Ðactions.€€Thus,€the€Hospital€may€close€its€Imaging€Department€without€violating€theÐ ¨ø ÐDefendantsðð€contractual€or€due€process€rights.ДäÐ Ð  Ðà  àà ` àà ¸ àà  àà h àà À àà  àÌà  àThe€case€was€decided€by€the€trial€court€€with€the€Motion€for€Summary€Judgment€of€PlaintiffsððÐ l¼ Ðbeing€granted€and€the€Motion€for€Summary€Judgment€of€Defendantsðð€being€denied.€€The€DefendantsÐ X ¨ Ðfiled€a€timely€appeal.Ð D!” ÐÌà  àAn€appeal€from€a€grant€of€summary€judgment€brings€the€case€before€the€appellate€courts€onÐ #l! Ðquestions€of€law€only,€subject€to€òòde€novoóó€review€accompanied€by€no€presumption€of€correctness€ofÐ $X" Ðthe€disposition€made€by€the€trial€court.€€òòGonzales€v.€Alman€Constr.€Co.óó,€857€S.W.2d€42€(Tenn.€Ct.Ð ô$D # ÐApp.€1993).€€The€burden€rests€upon€the€party€seeking€summary€judgment€to€persuade€the€court€thatÐ à%0!$ Ðno€genuine€and€material€factual€issues€exist€and€that€the€movant€is€entitled€to€judgment€as€a€matterÐ Ì&"% Ðof€law.€€òòByrd€v.€Hallóó,€847€S.W.2d€208€(Tenn.€1993).€€In€ruling€on€a€motion€for€summary€judgment,Ð ¸'#& Ðboth€the€trial€court€and€the€Court€of€Appeals€must€look€to€all€of€the€evidence,€take€the€strongestÐ ¤(ô#' Ðlegitimate€view€of€the€evidence€in€favor€of€the€opponent€of€the€motion€and€allow€all€reasonableÐ )à$( Ðinferences€in€his€favor,€discarding€all€countervailing€evidence.€€After€having€done€so,€if€there€is€anyÐ |*Ì%) Ðdispute€as€to€any€material€determinative€evidence€or€any€doubt€as€to€the€conclusion€to€be€drawn€fromÐ h+¸&* Ðthe€whole€evidence,€the€motion€must€be€denied.€€òòDooley€v.€Everettóó,€805€S.W.2d€380€(Tenn.€Ct.€App.Ð ° Ð1990);€òòEvco€Corp.€v.€Rossóó,€528€S.W.2d€20€(Tenn.€1975).€€In€this€case,€the€facts€are€essentiallyÐ œì Ðstipulated€such€that€only€questions€of€law€are€before€the€Court,€and€these€questions€were€correctlyÐ ˆØ Ðdetermined€on€summary€judgment€motion.€€òòAllstate€Ins.€Co.€v.€Jordanóó,€16€S.W.3d€777€(Tenn.€Ct.Ð tÄ ÐApp.€1999).€Ð `° ÐÌà  àTwo€issues€control€the€case€on€appeal:€Ð 8 ˆ Ð1.à  àDo€Plaintiffs/Appellees€have€the€right€to€ð ðcloseðð€the€Imaging€Department€at€CRMC€by€meansÐ $ t Ðof€an€exclusive€provider€contract€and€thereby€preclude€Defendants/Appellantsðð€use€of€CRMCÐ  ` Ðimaging€facilities€and€support€staff?Ð ü L  Ð2.à  àIf€such€closing€is€authorized,€does€the€resulting€non„access€to€CRMC€imaging€facilities€andÐ è 8  Ðsupport€staff€violate€the€medical€staff€bylaws€of€CRMC€and€constitute€breach€of€contract€withÐ Ô$  ÐAppellants?Ð À  ÐÌà  àAs€to€the€first€issue,€CRMC€is€a€public€hospital,€as€opposed€to€a€private€hospital,€andÐ ˜è  ÐAppellants€rely€upon€the€long€standing€rule€in€Tennessee€that€a€licensed€physician€who€compliesÐ „Ô  Ðwith€hospital€rules€and€regulations€has€a€right€to€practice€medicine€in€the€public€hospitals€of€theÐ pÀ ÐState.€€òòSee€Henderson€v.€City€of€Knoxvilleóó,€9€S.W.2d€697,€698€(Tenn.€1928).€€The€decisive€questionÐ \¬ Ðon€this€issue€is€whether€or€not€the€rule€in€òòHendersonóó€and€its€progeny€survived€the€enactment€ofÐ H˜ ÐChapter€778€of€the€Public€Acts€of€1996,€now€codified€as€Tennessee€Code€Annotated€sections€7„57„Ð 4„ Ð601€to€604.€€On€November€25,€1998,€the€Attorney€General€provided€the€following€opinion:Ð  p ÐÌà8  àQUESTION:ÐøHÐ Ð  Ðà8  àDoes€Tennessee€Code€Annotated€ðð€7„57„601,€òòet€seq.óó,€authorize€a€public€hospital€toÐ ä4 Ðclose€its€medical€staff€to€licensed€Tennessee€physicians€in€good€standing,€thusÐ Ð  Ðoverruling€by€legislation€previous€case€law?м Ð Ð  ÐÌà8  àOPINION:ДäÐ Ð  Ðà8  àYes.€€Tenn.€Code€Ann.€ðð€7„57„603€extends€the€powers€and€rights€of€private€actÐ €Ð Ðmetropolitan€hospitals€to€private€act€hospital€authorities,€otherwise€known€as€publicÐ l¼ Ðhospitals.€€Tenn.€Code€Ann.€ðð€7„57„502€provides€metropolitan€hospitals€with€theÐ X ¨ Ðauthority€to€contract€exclusively€with€physicians.€€Previous€case€law€restricting€theÐ D!” Ðpublic€hospitalsðð€right€to€close€a€medical€staff,€therefore,€has€been€nullified€by€thisÐ 0"€  Ðstatutory€extension€of€authority.€Ð#l!Ð Ð  ÐÌà8  àOPINION€BY:Ðô$D #Ð Ð  Ðà8  àJOHN€KNOX€WALKUP,€Attorney€General€and€Reporter;€MICHAEL€E.€MOORE,Ð à%0!$ ÐSolicitor€General;€VICKIE€P.€HALL,€Assistant€Attorney€General.ÐÌ&"%Ð Ð  ÐÌà8  àOPINION€ANALYSIS:à0hÐ Ð àФ(ô#'hÐ hÐ  Ðà8  àThe€Private€Act€Hospital€Authority€Act€(the€ð ðActðð),€Tenn.€Code€Ann.€ðð€7„57„601,€òòetÐ )à$( Ðâ âseq.óó,€was€adopted€in€1996€to€extend€the€powers€of€the€metropolitan€hospitalÐ |*Ì%) Ðauthorities€to€the€private€act€hospitals.€€Tenn.€Code€Ann.€ðð€7„57„603€states€in€partÐ ° Ðthat:МìÐ Ð  Ðâ âÌà  àà8 ` àð ðA€private€act€hospital€authority,€.€.€.€has€as€supplemental€andÐ tÄ Ðadditional€rights€and€powers,€all€powers€granted€to€private€actÐ `° Ðmetropolitan€hospital€authorities€in€title€7,€chapter€57,€part€5.€.€.€.ðð€ÐL œ` x` x ÐÌà8  àTenn.€Code€Ann.€ðð€7„57„502(c)€states€in€part€that€a€hospital€authority,€in€the€exerciseÐ $ t Ðof€its€powers,€may:Ð `Ð Ð  ÐÌà  àà8 ` àð ð.€.€.€contract€for€or€otherwise€participate€solely€or€with€others€in€theÐ è 8  Ðownership€or€operation€of€a€hospital,€medical€or€health€programÐ Ô$  Ðproperties€and€facilities€and€properties,€facilities,€and€programsÐ À  Ðsupporting€or€relating€thereto€of€any€kind€and€nature€whatsoever€andÐ ¬ü  Ðin€any€form€of€ownership€whenever€the€board€of€trustees€in€itsÐ ˜è  Ðdiscretion€shall€determine€it€is€consistent€with€the€purposes€andÐ „Ô  Ðpolicies€of€this€part€or€any€private€act€applicable€to€it,€and€mayÐ pÀ Ðexercise€such€powers€regardless€of€the€competitive€consequencesÐ \¬ Ðthereof.ðð€ÐH˜` x` x ÐÌà8  àBased€on€the€language€of€that€statute,€a€public€hospital€may€contract€with€others€inÐ  p Ðfurtherance€of€the€hospitalððs€operation€regardless€of€the€competitive€consequencesÐ  \ Ðof€that€contract.€€Certainly€physicians€and€surgeons€are€an€integral€part€of€theÐ øH Ðoperation€of€any€hospital.€€It,€therefore,€follows€that€hospitals€may€contract€with€aÐ ä4 Ðparticular€physician€or€physician€group€exclusively€even€if€it€is€to€the€disadvantageÐ Ð  Ðof€other€similarly€qualified€physicians€or€groups.м Ð Ð  ÐÌà8  àThe€purpose€and€policy€for€the€enactment€of€Tenn.€Code€Ann.€ðð€7„57„501,€òòet€seq.óó,Ð ”ä Ðis€stated€in€part€as€follows:ЀÐÐ Ð  ÐÌà  àà8 ` àð ðThe€general€assembly€hereby€finds€that€the€demand€for€hospital,Ð X ¨ Ðmedical€and€health€care€services€is€rapidly€changing€as€is€the€way€andÐ D!” Ðmanner€in€which€such€services€are€purchased€and€delivered;€that€theÐ 0"€  Ðmarket€for€hospital€and€health€care€services€is€becoming€increasinglyÐ #l! Ðcompetitive;€and€that€the€hospital€and€other€health€care€providersÐ $X" Ðneed€flexibility€to€be€able€to€respond€to€changing€conditions€byÐ ô$D # Ðhaving€the€power€to€develop€efficient€and€cost„effective€methods€toÐ à%0!$ Ðprovide€for€hospital,€medical€and€health€care€needs.€€The€generalÐ Ì&"% Ðassembly€finds€that€public€hospitals€in€metropolitan€areas€areÐ ¸'#& Ðpresently€at€a€competitive€disadvantage,€and€that€significantÐ ¤(ô#' Ðinvestments€in€the€public€assets€of€private€act€metropolitan€hospitalÐ )à$( Ðauthorities€could€be€jeopardized€by€inability€to€compete€with€privateÐ |*Ì%) Ðhospitals€because€of€legal€constraints€upon€the€scope€of€theirÐ h+¸&* Ðoperations€and€limitations€upon€the€power€granted€to€public€hospitalsÐ ° Ðunder€existing€law.ððМì` x` x ÐÌà8  àIf€there€is€any€question€as€to€the€specific€language€in€Tenn.€Code€Ann.€ðð€7„57„502(c),Ð tÄ Ðclearly,€the€legislative€intent€for€the€enactment€of€the€statute,€and€the€subsequentÐ `° Ðenactment€of€the€Act,€is€to€enable€public€hospitals€to€compete€in€the€health€careÐ L œ Ðmarket.€€ð ðIt€is€generally€held€that€private€hospitals€have€the€right€to€exclude€licensedÐ 8 ˆ Ðphysicians€and€surgeons€from€the€use€of€the€hospital€for€any€cause€deemed€sufficientÐ $ t Ðby€its€managing€authorities.ðð€€òòNashville€Memorial€Hospital,€Inc.,€et€al.€v.€Binkleyóó,Ð  ` Ð534€S.W.2d€318€(Tenn.€1976).€€It€follows€then€that€the€power€to€ð ðcontact€for€orÐ ü L  Ðotherwise€participate€solely€or€with€others€in€the€.€.€.€operation€of€a€hospital€.€.€.ðð€isÐ è 8  Ðintended€to€give€public€hospitals€the€same€right€to€exclusively€contract€withÐ Ô$  Ðphysicians€or€surgeons,€regardless€of€the€affect€on€the€excluded€physicians.€€Tenn.Ð À  ÐCode€Ann.€ðð€7„57„502.€Ð¬ü Ð Ð  ÐÌà8  àThe€result€of€the€Act,€therefore,€is€to€nullify€court€decisions€under€prior€law€whichÐ „Ô  Ðheld€that€a€licensed€physician€who€complies€with€hospital€rules€and€regulations€hasÐ pÀ Ða€right€to€practice€medicine€in€the€stateððs€public€hospitals.€€òòHenderson€v.€City€ofÐ \¬ ÐKnoxville,€et€al.óó,€9€S.W.2d€697€(Tenn.€1928).ÐH˜Ð Ð  ÐÌà8  àAlthough€the€statute€in€question€does€not€prohibit€the€specific€action€by€a€publicÐ  p Ðhospital€set€out€in€this€opinion€request,€this€Opinion€does€not€address,€and€should€notÐ  \ Ðbe€construed€to€address,€other€provisions€of€federal€and€state€law€governingÐ øH Ðcompetitive€activity.€€Specifically,€this€Office€has€not€reviewed€and€takes€no€positionÐ ä4 Ðon€the€activity€in€question€under€applicable€provisions€of€the€Sherman€Act,€15€U.S.C.Ð Ð  Ððð€1€òòet€seq.óó,€the€Clayton€Act,€15€U.S.C.€ðð€12€òòet€seq.óó,€or€any€other€federal€law.€€Finally,Ð ¼  Ðthis€opinion€is€not€intended€to€analyze€any€other€actions€by€private€act€orÐ ¨ø Ðmetropolitan€hospital€authorities€that€might€conflict€with€Article€I,€Section€22€of€theÐ ”ä ÐTennessee€Constitution€or€with€Tenn.€Code€Ann.€ðð€47„25„101,€òòet€seq.ЀÐÐ Ð  ÐÌóóOp.€Attððy€Gen.€98„223€(1998).òòÐ X ¨ ÐÌà  àóóAfter€careful€consideration,€we€find€that€we€cannot€improve€on€the€reasoning€of€the€AttorneyÐ 0"€  ÐGeneral,€and€we,€therefore,€adopt€the€opinion€of€the€Attorney€General€as€the€opinion€of€the€Court.€Ð #l! ÐThe€Plaintiffs€are€empowered€to€close€the€Imaging€Department€of€CRMC€by€means€of€an€exclusiveÐ $X" Ðprovider€contract€and€òòHenderson€v.€City€of€Knoxville€óóand€its€progeny€have€been€legislativelyÐ ô$D # Ðoverruled€by€sections€7„57„601€to€604€of€the€Code.Ð à%0!$ ÐÌà  à€Turning€now€to€the€second€issue,€Appellants€assert€that€ð ðclosingðð€the€Imaging€DepartmentÐ ¸'#& Ðof€CRMC€to€qualified€radiologists€who€are€members€of€the€medical€staff€of€the€hospital€constitutesÐ ¤(ô#' Ða€breach€of€the€contract€between€the€hospital€and€the€affected€radiologists.€€Relying€on€the€nearÐ )à$( Ðâ âuniversal€rule€in€òòLewisburg€Community€Hospital€v.€Alfredsonóó,€805€S.W.2d€756€(Tenn.€1991),€thatÐ |*Ì%) Ðhospital€bylaws€and€medical€staff€bylaws€are€an€integral€part€of€the€contract€between€the€hospital€andÐ ° Ðits€medical€staff€members,€Appellants€point€to€certain€provisions€of€these€bylaws.Ð œì Ðâ âÌÌà  àà ` àARTICLE€III:€€òòSTAFF€MEMBERSHIPóóÐ `° ÐÌà8  à3.1à0` Ð Ð àNATURE€OF€STAFF€MEMBERSHIPÐ8 ˆ` Ð ` Ð  ÐÌà8  àMembership€on€the€medical€staff€of€Cookeville€General€Hospital€is€a€privilege€whichÐ  ` Ðshall€be€extended€only€to€professionally€competent€physicians,€dentists€andÐ ü L  Ðpodiatrists€who€continuously€meet€the€qualifications,€standards€and€requirements€setÐ è 8  Ðforth€in€these€bylaws.€€Appointment€to€and€membership€on€the€staff€shall€confer€onÐ Ô$  Ðthe€staff€member€only€such€clinical€privileges€and€prerogatives€as€have€been€grantedÐ À  Ðby€the€board€in€accordance€with€these€bylaws,€and€shall€include€staff€category,€andÐ ¬ü  Ðdepartment€assignments.Иè Ð Ð  ÐÌà  àà ` à.€.€.€.Ð pÀ ÐÌà  àà8 ` à3.2„3à0¸ ` x` xàNondiscriminationÐH˜¸ x¸ x Ðà  àà8 ` àStaff€membership€or€particular€clinical€privileges€shall€not€be€deniedÐ 4„ Ðon€the€basis€of€any€criterion€unrelated€to€the€efficient€delivery€ofÐ  p Ðpatient€care€at€the€generally€recognized€professional€level€of€qualityÐ  \ Ðin€the€hospital,€including,€but€not€limited€to,€sex,€race,€creed,€religiousÐ øH Ðbeliefs€and€national€origin€or€to€an€otherwise€qualified€handicappedÐ ä4 Ðpractitioner.ÐÐ ` x` x ÐÌà  àà ` à.€.€.€.Ð ¨ø ÐÌà  àà ` àARTICLE€XIV:€€òòGENERAL€PROVISIONSóóÐ €Ð ÐÌà  à14.1€MEDICAL€STAFF€RULES€&€REGULATIONSà È àÐ X ¨ ÐÌà  àà ` à.€.€.€.Ð 0"€  ÐÌà  àà8 ` àD.à0¸ ` x` xàòòMedical€Staff€Role€in€Exclusive€Contractingóó:€€The€MedicalÐ $X" ÐStaff,€through€the€Medical€Executive€Committee,€withÐ ô$D # Ðmedical€staff€approval,€shall€review€and€makeÐ à%0!$ Ðrecommendations€to€the€Board€regarding€issues€related€to€theÐ Ì&"% Ðexclusive€arrangements€for€physician€and/or€professionalÐ ¸'#& Ðservices,€prior€to€any€decision€being€made,€in€the€followingÐ ¤(ô#' Ðsituations:Ð)à$(¸ x¸ x Ðà  àà ` àà8 ¸ à1.€€the€decision€to€execute€an€exclusive€contract€in€a€Ð |*Ì%) Ѐ€€€€previously€open€department€or€service;Ðh+¸&*¸ ¸  Ðà  àà ` àà8 ¸ à2.€€the€decision€to€renew€or€modify€an€exclusive€€€€€€€€Ð ° Ѐ€€€€contract€in€a€particular€department€or€service;Ðœì¸ ¸  Ðà  àà ` àà8 ¸ à3.€€the€decision€to€terminate€an€exclusive€contract€in€Ð ˆØ Ѐ€€€€a€particular€department€or€service.Ðtĸ ¸  ÐÌà  àà ` à.€.€.€.Ð L œ ÐÌà  àà ` àARTICLE€XVI:€€òòFAIR€HEARING€PLANóóÐ $ t ÐÌà  àà ` à.€.€.€.Ð ü L  ÐÌà8  à16.1„1à0` Ð Ð àINITIATION€OF€HEARINGÐÔ$ ` Ð ` Ð  ÐÌà  àà8 ` à16.1„1€Recommendations€or€ActionsЬü ` x` x ÐÌà  àà8 ` àThe€following€recommendations€or€actions€shall,€if€deemed€adverseÐ „Ô  Ðpursuant€to€Section€16.1„2,€entitle€the€practitioner€affected€thereby€toÐ pÀ Ða€hearing:Ð\¬` x` x Ðà  àà ` àA.à0 ¸ àDenial€of€initial€staff€appointment,ÐH˜¸ (#¸ (# Ðà  àà ` àB.à0 ¸ àDenial€of€reappointment,Ð4„¸ (#¸ (# Ðà  àà ` àC.à0 ¸ àSuspension€of€staff€appointment,Ð p¸ (#¸ (# Ðà  àà ` àD.à0 ¸ àRevocation€of€staff€appointment,Ð \¸ (#¸ (# Ðà  àà ` àE.à0 ¸ àDenial€of€requested€modification€of€staff€category,ÐøH¸ (#¸ (# Ðà  àà ` àF.à0 ¸ àReduction€in€staff€category,Ðä4¸ (#¸ (# Ðà  àà ` àG.à0 ¸ àLimitation€of€admitting€prerogatives,ÐÐ ¸ (#¸ (# Ðà  àà ` àH.à0 ¸ àDenial€of€requested€department€assignment,м ¸ (#¸ (# Ðà  àà ` àI.à0 ¸ àDenial€of€requested€clinical€privileges,Шø¸ (#¸ (# Ðà  àà ` àJ.à0 ¸ àReduction€in€clinical€privileges,Ð”ä¸ (#¸ (# Ðà  àà ` àK.à0 ¸ àSuspension€of€clinical€privileges,Ѐи (#¸ (# Ðà  àà ` àL.à0 ¸ àRevocation€of€clinical€privileges,Ðl¼¸ (#¸ (# Ðà  àà ` àM.à0 ¸ àTerms€of€probation,ÐX ¨¸ (#¸ (# Ðà  àà ` àN.à0 ¸ àRequirement€of€consultation,ÐD!”¸ (#¸ (# ÐÓ  ÓAND/ORÐ 0"€  ÐÓ  Óà  àà ` àO.à0 ¸ àLetter€of€admonition€or€letter€of€reprimand.à0ȸ (#¸ (#àà0 È(#È(#àÐ#l! (# (# ÐÌà  àThe€pivotal€and€decisive€question€involves€the€holding€of€the€Supreme€Court€in€òòAlfredsonóó.€Ð ô$D # ÐWhile€it€is€not€open€to€legitimate€dispute€that€the€medical€staff€bylaws€are€an€integral€part€of€theÐ à%0!$ Ðcontract€between€Appellants€and€Appellees,€as€òòAlfredsonóó€correctly€holds,€it€is€the€effect€of€closureÐ Ì&"% Ðof€the€hospital€Imaging€Department€on€the€contractual€rights€of€Appellants€that€puts€òòAlfredsonóó€atÐ ¸'#& Ðodds€with€every€other€jurisdiction€that€has€addressed€the€issue.€€In€òòAlfredsonóó,€the€Supreme€CourtÐ ¤(ô#' Ðheld:Ð )à$( Ðâ âÐ |*Ì%) Ðà8  àAfter€the€foregoing€analysis,€the€Court€of€Appeals€observed,€and€we€agree,€à8@„` x` xàIt€is€fairÐ ° Ðâ âto€conclude€that€the€hospital€granted€Dr.€Alfredson€specific,€delineated€clinicalÐ œì Ðprivileges€enabling€him€to€practice€radiology€at€the€hospital.€€His€contract€requiredÐ ˆØ Ðthem.€€The€bylaws€themselves€required€that€he€seek€them€and€likewise€required€theÐ tÄ Ðhospital€to€grant€them.€€With€such€hospital„based€specialties€such€as€radiology,€theÐ `° Ðinability€to€use€the€hospital€facilities€and€staff€would€have€rendered€the€clinicalÐ L œ Ðprivileges€meaningless.€€Thus,€necessarily€included€with€Dr.€Alfredsonððs€privilegesÐ 8 ˆ Ðwas€the€right€to€use€hospital€facilities€and€staff.Ð$ tÐ Ð  ÐÌà  àà ` à.€.€.€.Ð ü L  ÐÌà8  àà ` àWe,€therefore,€hold€that€the€Hospitalððs€refusal€to€give€Dr.€Alfredson€accessÐ Ô$  Ðto€its€radiological€equipment€and€staff€after€January€2,€1986,€significantly€reduced€hisÐ À  Ðprivileges.€€It€follows€that€Dr.€Alfredson€was€entitled€to€a€hearing€under€the€medicalÐ ¬ü  Ðstaff€bylaws,€and€that€the€Hospital€breached€its€contract€by€failing€to€provide€him€aÐ ˜è  Ðhearing.€€As€a€result,€we€affirm€the€Court€of€Appealsðð€holding€that€the€Hospital€wasÐ „Ô  Ðnot€entitled€to€a€summary€dismissal€of€Dr.€Alfredsonððs€claims€arising€from€theÐ pÀ ÐHospitalððs€failure€to€follow€its€bylaws,€and€affirm€its€action€vacating€the€HospitalððsÐ \¬ Ðsummary€judgment€in€part.€€We€reverse€the€Court€of€Appealsðð€decision€that€genuineÐ H˜ Ðfactual€issues€exist€concerning€whether€the€Hospital€significantly€curtailed€Dr.Ð 4„ ÐAlfredsonððs€clinical€privileges€by€denying€him€access€to€its€radiological€equipmentÐ  p Ðand€staff,€and€its€resulting€remand€to€the€trial€court.Ð \Ð Ð  Ðà8  àà ` àHaving€determined€that€Dr.€Alfredsonððs€clinical€privileges€are€sufficiently€setÐ øH Ðout€in€the€record€for€this€purpose,€we€hold,€as€a€matter€of€law,€that€his€privileges€wereÐ ä4 Ðsignificantly€reduced€when€the€Hospital€denied€him€access€to€its€equipment€and€itsÐ Ð  Ðstaff.€€It€follows€that€the€medical€staff€bylaws€required€the€Hospital€to€grant€him€aÐ ¼  Ðhearing€when€his€clinical€privileges€were€significantly€reduced,€and€that€by€not€doingÐ ¨ø Ðso,€the€Hospital€breached€its€contract.ДäÐ Ð  ÐÌòòAlfredsonóó,€805€S.W.2d€at€761„62.Ð l¼ ÐÌà  àWithout€mentioning€òòAlfredsonóó,€the€trial€court€held:€€ð ðThus,€the€Hospital€may€close€itsÐ D!” ÐImaging€Department€without€violating€the€Defendantððs€contractual€or€due€process€rights.ðð€€In€soÐ 0"€  Ðholding,€the€trial€court€followed€the€apparently€universal€rule€applied€in€other€jurisdictions,€whichÐ #l! Ðrule€is€contra€to€òòAlfredsonóó.€€òòSee€Adler€v.€Montefiore€Hosp.€Assððn€of€W.Pa.óó,€311€A.2d€634€(Pa.€1973);Ð $X" ÐòòAnne€Arundel€Gen.€Hosp.€v.€OððBrienóó,€432€A.2d€483€(Md.€1981);€òòEngelstad€v.€Virginia€Mun.€Hosp.óó,Ð ô$D # Ð718€F.2d€262€(8òòthóó€Cir.€1983);€òòCollins€v.€Associated€Pathologists,€Ltdóó,€844€F.2d€473€(7òòthóó€Cir.€1988);Ð à%0!$ ÐòòHolt€v.€Good€Samaritan€Hosp.€&€Health€Ctr.óó,€590€N.E.2d€1318€(Ohio€1990);€òòBartley€v.€EasternÐ Ì&"% ÐMaine€Med.€Ctr.óó,€617€A.2d€1020€(Me.1992);€òòDutta€v.€St.€Francis€Reg.€Med.€Ctr.óó,€867€P.2d€1057Ð ¸'#& Ð(Kan.€1994);€òòGonzalez€v.€San€Jacinto€Methodist€Hosp.óó,€880€S.W.2d€436€(Tex.€1994);€òòBryant€v.€GlenÐ ¤(ô#' ÐOaks€Med.€Ctr.óó,€650€N.E.2d€622€(Ill.€App.€Ct.€1995);€òòGaribaldi€v.€Applebaumóó,€742€N.E.2d€279€(Ill.Ð )à$( Ð2000);€òòVan€Valkenburg€v.€Paracelsus€Healthcare€Corp.óó,€606€N.W.2d€908€(N.D.€2000).òò€€óó€Ð |*Ì%) ÐÐ h+¸&* Ðà  àIn€addressing€the€effect€on€the€constitutional€and€contractual€rights€of€medical€staffÐ ° Ðphysicians€effected€by€exclusive€contract€closure€of€the€hospital€emergency€department,€the€SupremeÐ œì ÐCourt€of€North€Dakota€held:Ð ˆØ ÐÌà8  àà ` àRelying€on€òòLewisburg€Community€Hosp.€v.€Alfredsonóó,€805€S.W.2d€756Ð `° Ð(Tenn.€1991),€the€plaintiffs€argue€the€defendants€breached€the€medical€staff€bylawsÐ L œ Ðby€not€adhering€to€the€due€process€and€hearing€provisions.€€In€òòAlfredsonóó,€805€S.W.2dÐ 8 ˆ Ðat€761,€the€court€held€a€hospitalððs€termination€of€a€radiologistððs€exclusive€contractÐ $ t Ðand€denial€of€access€to€hospital€equipment€and€staff€ð ðsignificantly€reducedðð€theÐ  ` Ðradiologistððs€privileges.€€The€court€held€the€hospital€breached€its€contract€by€failingÐ ü L  Ðto€provide€the€radiologist€a€hearing€under€the€medical€staff€bylaws.€€òòId.óóÐè 8 Ð Ð  Ðà8  àà ` àThe€majority€of€courts,€however,€have€rejected€the€rational€of€òòAlfredson€óóandÐ Ô$  Ðhave€held€hearing€and€due€process€provisions€in€similar€medical€staff€bylaws€are€notÐ À  Ðimplicated€unless€there€are€allegations€against€a€physician€bearing€on€professionalÐ ¬ü  Ðcompetency€and€conduct.€òòóó€We€agree€with€the€majority€of€courts,€and€we€hold€theÐ ˜è  Ðhearing€and€due€process€provisions€of€the€Hospitalððs€medical€staff€bylaws€are€notÐ „Ô  Ðimplicated€unless€there€are€allegations€bearing€on€professional€competency,€conduct,Ð pÀ Ðor€character.Ð\¬Ð Ð  Ðà8  àà ` àHere,€the€plaintiffsðð€medical€privileges€were€not€revoked€or€suspended,€andÐ H˜ Ðthere€were€no€allegations€bearing€on€professional€competency,€conduct,€or€character.€Ð 4„ ÐRather,€the€plaintiffs€were€not€assigned€staff€coverage€in€the€Hospitalððs€emergencyÐ  p Ðdepartment.€€The€right€to€exercise€medical€privileges€is€separate€from€the€granting€orÐ  \ Ðrevoking€of€those€privileges,€and€a€physician€with€privileges€is€not€guaranteedÐ øH Ðemployment€or€the€free€and€unfettered€right€to€use€a€facility€to€exercise€thoseÐ ä4 Ðprivileges.€€òòóóWe€conclude,€as€a€matter€of€law,€the€hearing€and€due€process€provisionsÐ Ð  Ðof€the€Hospitalððs€medical€staff€bylaws€were€not€implicated€in€this€case.м Ð Ð  ÐòòÌVan€Valkenburgóó,€606€N.W.2d€at€917„18€(citations€omitted).Ð ”ä ÐÌà  àAddressing€the€contractual€and€due€process€rights€of€a€radiologist€excluded€by€exclusiveÐ l¼ Ðcontract€closure€of€a€hospital€radiology€department,€the€Supreme€Court€of€Kansas€held:Ð X ¨ ÐÌà8  àà ` àWe€believe€the€bylaws,€when€considered€as€a€whole,€support€the€conclusionÐ 0"€  Ðof€the€Court€of€Appeals€that€Dutta€was€not€entitled€to€a€hearing€because€the€hospitalððsÐ #l! Ðmanagerial€decision€was€based€on€business€considerations.€€The€Court€of€AppealsÐ $X" Ðdistinguished€a€case€relied€on€by€Dutta,€òòLewisburg€Community€Hosp.€v.€Alfredsonóó,Ð ô$D # Ð805€S.W.2d€756€(Tenn.€1991),€on€the€basis€that€St.€Francisðð€bylaws€limit€aÐ à%0!$ Ðphysicianððs€right€to€a€hearing€to€those€matters€bearing€on€professional€competencyÐ Ì&"% Ðand€conduct.€€18€Kan.App.2d€at€253.€€We€agree.€€The€threshold€issue€in€òòLewisburgóóÐ ¸'#& Ðwas€whether€the€bylaws€formed€a€contract€with€the€plaintiff€radiologist€as€a€memberÐ ¤(ô#' Ðof€the€medical€staff.€€805€S.W.2d€at€759.€€St.€Francis,€in€the€case€at€bar,€has€admittedÐ )à$( Ðthe€contractual€relationship.€€We€find€no€reference€in€òòLewisburgóó€to€a€bylawsÐ |*Ì%) Ðprovision€limiting€hearings€to€matters€of€professional€competency.€€The€hospitalÐ h+¸&* Ðbylaws€in€òòLewisburgóó€were€construed€to€require€the€hospital€to€permit€the€use€ofÐ ° Ðcertain€facilities€by€physicians€granted€clinical€privileges€in€a€particular€specialty.€Ð œì Ð805€S.W.2d€at€761.€€No€such€requirement€appears€in€the€St.€Francis€bylaws.€€TheÐ ˆØ Ðweight€of€authority€supports€the€conclusion€of€the€Court€of€Appeals.€€òòLewisburgóóÐ tÄ Ðappears€to€be€the€only€contrary€authority.€€We€are€unpersuaded€by€the€reasoning€inÐ `° ÐòòLewisburgóó.€€A€parallel€medical€employment€issue€was€recently€reviewed€in€òòBartleyÐ L œ Ðv.€Eastern€Maine€Medical€Centeróó,€617€A.2d€1020€(Me.€1992).€€òòBartley€óóheld€thatÐ 8 ˆ Ðbecause€the€staff€privileges€of€the€plaintiff€emergency€department€physicians€had€notÐ $ t Ðbeen€revoked€or€reduced,€the€physicians€were€not€entitled€to€notice€and€hearing€underÐ  ` Ðthe€hospital€bylaws.€€The€physicians€in€òòBartleyóó€were€notified€that€they€could€noÐ ü L  Ðlonger€work€in€the€emergency€room€unless€they€negotiated€new€employmentÐ è 8  Ðcontracts€with€the€hospital.€€The€physiciansðð€staff€privileges€were€not€terminatedÐ Ô$  Ðwhen€the€hospital€made€different€arrangements€for€staffing€the€emergencyÐ À  Ðdepartment.€€The€òòBartleyóó€court€noted€that€there€is€a€distinction€between€a€grant€ofÐ ¬ü  Ðprivileges€and€the€right€to€exercise€privileges.€€òòBartleyóó€found€that€the€hospital€bylawsÐ ˜è  Ðdid€not€apply€to€the€emergency€room€physiciansðð€terminations€because€there€had€beenÐ „Ô  Ðno€allegation€of€unprofessional€conduct€or€privilege€reduction.€€617€A.2d€at€1021.€Ð pÀ ÐSee€òòCollins€v.€Associated€Pathologists,€Ltd.óó,€844€F.2d€473,€481€(7òòthóó€Cir.),€òòcert.€deniedóóÐ \¬ Ð488€U.S.€852,€109€S.Ct.€137,€102€L.Ed.2d€110€(1988);€òòEngelstad€v.€Virginia€Mun.Ð H˜ ÐHosp.óó,€718€F.2d€262,€268€(8òòthóó€Cir.€1983);€òòLewin€v.€St.€Joseph€Hospital€of€Orangeóó,€82Ð 4„ ÐCal.App.3d€368,€391,€146€Cal.Rptr.€892€(1978);€òòAnne€Arundel€Gen.€Hosp.€v.Ð  p ÐOððBrienóó,€49€Md.App.€362,€371„73,€432€A.2d€483€(1981);€òòHolt€v.€Good€SamaritanÐ  \ ÐHosp.€&€Health€Ctr.óó,€69€Ohio€App.3d€439,€445„46,€590€N.E.2d€1318€(1990);€andÐ øH ÐòòAdler€v.€Montefiore€Hosp.€of€W.Pa.óó,€453€Pa.€60,€80„81,€311€A.2d€634€(1973),€òòcert.Ð ä4 Ðdeniedóó€414€U.S.€1131,€94€S.Ct.€870,€38€L.Ed.2d€755€(1974).ÐÐ Ð Ð  ÐòòÌDuttaóó,€867€P.2d€at€1062„63.Ð ¨ø ÐÌà  àAs€an€intermediate€appellate€court,€we€are€bound€by€òòAlfredsonóó,€and€unless€the€case€has€beenÐ €Ð Ðlegislatively€overruled€by€Chapter€778€of€the€Public€Acts€of€1996€(sections€7„57„601€to€604€of€theÐ l¼ ÐCodeòòóó),€we€are€bound€to€follow€it.€€Thus,€this€case€would€have€to€be€reversed€and€remanded€asÐ X ¨ ÐAppellees€must€grant€a€hearing€to€the€Appellants€pursuant€to€the€medical€staff€bylaws.Ð D!” ÐÌòòà  àóóHowever,€òòAlfredsonóó€was€decided€by€the€Tennessee€Supreme€Court€on€March€4,€1991.€Ð #l! ÐChapter€119€of€the€Public€Acts€of€1995€(codified€as€Tennessee€Code€Annotated€sections€7„57„501Ð $X" Ðto€504)€was€effective€April€19,€1995,€and€chapter€778€of€the€Public€Acts€of€1996€(codified€asÐ ô$D # ÐTennessee€Code€Annotated€sections€7„57„601€to€604)€òòóówas€effective€April€17,€1996.€€The€contractÐ à%0!$ Ðbetween€CRMC€and€Dr.€Mead€was€renewed€for€a€two€year€term€in€February€of€1998.€€The€contractsÐ Ì&"% Ðbetween€CRMC€and€Drs.€Humphrey,€Limbacher€and€Coonce€were€renewed€in€1999€for€a€period€ofÐ ¸'#& Ðtwo€years.€€Thus,€both€Tennessee€Code€Annotated€sections€7„57„501€to€504òòóó€and€Tennessee€CodeÐ ¤(ô#' ÐAnnotated€sections€7„57„601€to€604€òòóópost„dated€the€òòAlfredsonóó€decision€and€pre„dated€each€of€the€fourÐ )à$( Ðâ âcontracts€in€issue€in€this€case.€€As€the€contracts€in€issue€post„date€the€legislative€enactments€involved,Ð |*Ì%) Ðthere€can€be€no€impairment€of€the€obligation€of€contract.€€òòMunday€v.€Wisconsin€Trust€Co.óó,€252€U.S.Ð ° Ð499€(1920).Ð œì Ðâ âÌà  àCertain€settled€rules€must€be€considered€in€determining€the€effect€of€legislative€actsÐ tÄ Ðintervening€between€the€decision€in€òòAlfredsonóó€and€the€contracts€between€CRMC€and€the€Appellants.Ð `° ÐÌ1.à  àThe€General€Assembly€is€presumed€to€know€the€existing€state€of€the€law€on€the€subject€underÐ 8 ˆ Ðconsideration€when€it€enacts€legislation.€€òòHolder€v.€Tennessee€Judicial€Selection€Commððnóó,€937Ð $ t ÐS.W.2d€877€(Tenn.€1996);€òòSunTrust€Bank€of€Nashville€v.€Johnsonóó,€46€S.W.3d€216€(Tenn.€Ct.€App.Ð  ` Ð2000).Ð ü L  ÐÌ2.à  àA€statute€is€to€be€construed€with€reference€to€pre„existing€law€and€does€not€change€such€lawÐ Ô$  Ðfurther€than€it€expressly€declares€or€necessarily€implies.€€òòIn€re:€€Deskinsðð€Estatesóó,€381€S.W.2d€921Ð À  Ð(Tenn.€1964);€òòWinter€v.€Smithóó,€914€S.W.2d€527€(Tenn.€Ct.€App.€1995).Ð ¬ü  ÐÌ3.à  àThe€court€should€consider€the€existing€state€of€the€law,€the€circumstances€contemporaneousÐ „Ô  Ðto€the€enactment€of€a€new€law,€the€facts€which€induced€the€new€law,€and€the€evils€sought€to€beÐ pÀ Ðremedied.€€òòFirst€National€Bank€v.€Howardóó,€253€S.W.2d€961€(Tenn.€1923);€òòStill€v.€First€Tenn.€Bankóó,Ð \¬ ÐòòN.A.óó,€900€S.W.2d€282€(Tenn.€1995);€òòWachovia€Bank€of€N.€C.€v.€Johnsonóó,€26€S.W.3d€621€(Tenn.€Ct.Ð H˜ ÐApp.€2000).Ð 4„ ÐÌ4.à  àWhen€the€court€can€gather€the€paramount€intention€of€the€legislative€action,€such€intentionÐ  \ Ðmust€be€given€effect€although€thereòò€óómay€exist€some€apparent€obstacles.€€òòRawlins€v.€Braswellóó,€231Ð øH ÐS.W.2d€1021€(Tenn.€1950);€òòStillóó,€900€S.W.2d€282.Ð ä4 ÐÌApplying€such€rules€we€must€now€determine€the€legislative€intent€in€the€enactment€of€sections€7„57„Ð ¼  Ð501€to€504€òòóóand€sections€7„57„601€to€604€of€the€Code.Ð ¨ø ÐÌà  àIt€is€sections€7„57„601€to€604òòóó,€entitled€ð ðPrivate€Act€Hospital€Authority€of€1996,ðð€that€governsÐ €Ð Ðthe€issues€in€this€case,€but€we€are€legislatively€commanded€by€Tennessee€Code€Annotated€sectionÐ l¼ Ð7„57„603€(1998)€that€ð ð[a]€private€act€hospital€authority,€as€defined€in€this€part,€in€addition€to€theÐ X ¨ Ðrights€and€powers€granted€to€such€authority€by€any€private€act€of€the€general€assembly€or€its€charterÐ D!” Ðof€incorporation,€has€as€supplemental€and€additional€rights€and€powers,€all€powers€granted€to€privateÐ 0"€  Ðact€metropolitan€hospital€authorities€in€title€7,€chapter€57,€part€5.ðð€€Turning€then€to€Title€7,€ChapterÐ #l! Ð57,€part€5€of€Tennessee€Code€Annotated,€the€declared€intent€of€the€legislature€is€expressed€in€sectionÐ $X" Ð7„57„501.Ð ô$D # ÐÌà8  àà ` àThe€general€assembly€hereby€finds€that€the€demand€for€hospital,€medical€andÐ Ì&"% Ðhealth€care€services€is€rapidly€changing€as€is€the€way€and€manner€in€which€suchÐ ¸'#& Ðservices€are€purchased€and€delivered;€that€the€market€for€hospital€and€health€careÐ ¤(ô#' Ðservices€is€becoming€increasingly€competitive;€and€that€the€hospital€and€other€healthÐ )à$( Ðcare€providers€need€flexibility€to€be€able€to€respond€to€changing€conditions€by€havingÐ |*Ì%) Ðthe€power€to€develop€efficient€and€cost„effective€methods€to€provide€for€hospital,Ð h+¸&* Ðmedical€and€health€care€needs.€€The€general€assembly€also€finds€that€the€increasingÐ ° Ðcompetition€and€changing€conditions€force€hospitals€and€other€health€care€providersÐ œì Ðto€develop€market€strategies€and€strategic€plans€to€effectively€compete.€€The€generalÐ ˆØ Ðassembly€further€finds€that€public€hospitals€in€metropolitan€areas€are€presently€at€aÐ tÄ Ðcompetitive€disadvantage,€and€that€significant€investments€in€the€public€assets€ofÐ `° Ðprivate€act€metropolitan€hospital€authorities€could€be€jeopardized€by€inability€toÐ L œ Ðcompete€with€private€hospitals€because€of€legal€constraints€upon€the€scope€of€theirÐ 8 ˆ Ðoperations€and€limitations€upon€the€power€granted€to€public€hospitals€under€existingÐ $ t Ðlaw.Ð `Ð Ð  ÐÌTenn.€Code€Ann.€ðð7„57„501(b)(1998).Ð è 8  ÐÌà  àIn€furtherance€of€the€general€purposes€set€forth€in€section€7„57„501(b)€of€the€Code,€theÐ À  ÐGeneral€Assembly€granted€specific€powers€that€are€set€forth€in€section€7„57„502€and€concluded€suchÐ ¬ü  Ðdesignation€of€specific€powers€with€a€declaration€of€legislative€intent€that€is€too€clear€to€leaveÐ ˜è  Ðsubstantial€doubt.Ð „Ô  ÐÌà8  à(c)€In€the€exercise€of€its€powers,€including,€without€limitation,€the€powers€in€thisÐ \¬ Ðsection,€any€other€provision€of€this€part€and€of€any€other€law€a€private€actÐ H˜ Ðmetropolitan€hospital€authority€may€acquire,€manage,€lease,€purchase,€sell,€contractÐ 4„ Ðfor€or€otherwise€participate€solely€or€with€others€in€the€ownership€or€operation€ofÐ  p Ðhospital,€medical€or€health€program€properties€and€facilities€and€properties,€facilities,Ð  \ Ðand€programs€supporting€or€relating€thereto€of€any€kind€and€nature€whatsoever€andÐ øH Ðin€any€form€of€ownership€whenever€the€board€of€trustees€in€its€discretion€shallÐ ä4 Ðdetermine€it€is€consistent€with€the€purposes€and€policies€of€this€part€or€any€private€actÐ Ð  Ðapplicable€to€it,€òòand€may€exercise€such€powers€regardless€of€the€competitiveÐ ¼  Ðconsequences€thereofóó.€Ð¨øÐ Ð  ÐÌTenn.€Code€Ann.€ðð€7„57„502(c)€(1998)€(emphasis€added).€€Among€the€ð ðcompetitive€consequencesððÐ €Ð Ðnecessarily€envisioned€by€such€enactment€are€the€significant€reductions€in€clinical€privileges€ofÐ l¼ Ðcompeting€staff€physicians€displaced€by€an€administrative€business€decision€to€ð ðcloseðð€a€departmentÐ X ¨ Ðof€a€hospital€by€means€of€an€exclusive€contract.Ð D!” ÐÌà  àThere€being€no€impairment€in€the€obligation€of€existing€contracts€in€this€case,€it€would€appearÐ #l! Ðthat€CRMC€acted€within€the€scope€of€its€powers€under€Tennessee€Code€Annotated€sections€7„57„601Ð $X" Ðto€604òòóó€when€it€made€the€business€decision€to€ð ðcloseðð€its€radiology€department€by€exclusive€contract.Ð ô$D # ÐThe€ð ðcompetitive€consequencesðð€to€staff€radiologists€not€employed€by€the€exclusive€provider€areÐ à%0!$ Ðlegislatively€mandated.Ð Ì&"% ÐÌCONCLUSIONÐ ¤(ô#' ÐÌà  àòòLewisburg€Community€Hospital€v.€Alfredsonóó€is€a€pronouncement€by€the€Supreme€Court€ofÐ |*Ì%) ÐTennessee€that€this€intermediate€appellate€court€is€mandated€to€follow€in€the€absence€of€legislativeÐ h+¸&* Ðaction€so€clear€as€to€leave€no€room€for€doubt.€€Such,€in€our€judgment,€is€the€effect€of€Code€sectionsÐ ° Ð7„57„601€to€604.€€Tòòóóhe€judgment€of€the€trial€court€is€in€all€respects€affirmed.€€However,€the€last€wordÐ œì Ðstill€rests€with€the€Supreme€Court€of€Tennessee.Ð ˆØ ÐÌà  àThe€case€is€remanded€to€the€trial€court€for€such€further€proceedings€as€may€be€necessary€andÐ `° Ðproper.Ð L œ ÐÌà  àCosts€of€the€cause€are€assessed€against€the€Appellants.€Ð $ t ÐÌÌÌà  àà ` àà ¸ àà  àà h àà À àà  à___________________________________€Ð Ô$  Ðà  àà ` àà ¸ àà  àà h àà À àà  àWILLIAM€B.€CAIN,€JUDGE