Tenn. Code Ann. § 68-1-703

In order to ensure cooperation and acceptance of the purposes of this part by the community to be served, the sponsor of any new primary health care center shall, prior to the establishment of a new primary health care center in a community, obtain the approval of the appropriate health systems agency and the primary care advisory board, including those centers that utilize, or plan to utilize, federal funds, either as grants, or as fees receivable as reimbursements for services delivered for medicare or medicaid patients.