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Bill Summary · HB 455

Summary — HB 455: "Repeal Certificate of Need Laws"

Status: Introduced Nov 12, 2024; Passed 1st Reading (most recent status provided).
Primary subject areas: Certificates of Need (CON), hospitals and clinics, health facility definitions and licensing, Department of Health and Human Services (DHHS), public health.

Purpose / Intent

HB 455 would eliminate North Carolina’s Certificate of Need (CON) regime — the statutory framework that requires health care providers to obtain state approval before building or expanding many kinds of health care facilities or services. The bill removes or revises multiple statutory cross‑references to CON requirements and redefines affected health‑care terms so they are no longer tied to CON law.

Key provisions and statutory changes

  • Repeals or rewrites provisions that reference CON requirements (primarily Article 9 of Chapter 131E) across a number of North Carolina statutes. The bill’s text amends many code sections to remove the legal effect of CON requirements.
  • Updates definitions and cross‑references in statutes governing:
    • Health facility and provider definitions (e.g., hospitals, ambulatory surgical facilities, long‑term care hospitals, nursing homes, hospice, intermediate care facilities).
    • Insurance and long‑term care coverage definitions that rely on CON‑based facility definitions.
    • Licensing and electronic health record reporting obligations for hospitals and other providers (statutory references are adjusted to decouple them from CON language).
  • Amends appellate and attorney‑fee related statutes (e.g., G.S. 6‑19.1, G.S. 7A‑29) to address appeals and fee recovery in administrative challenges; the bill explicitly treats contested cases tied to the former CON provisions.
  • Makes conforming amendments across numerous chapters (including Chapters 58, 90, 113A, 122C, and others) where statutory language previously referenced CON requirements or CON‑related definitions.

(Exact section-by-section repeals/edits are extensive; the bill’s text shows many scattered, targeted amendments to eliminate CON references and adjust related definitions.)

Who would be affected

  • Health care providers/developers: hospitals, ambulatory surgical centers, dialysis clinics, hospice providers, long‑term and psychiatric facilities, nursing homes, intermediate care facilities, home‑health providers, and others currently subject to CON review.
  • State agencies: DHHS (and any CON program offices) would see changes in regulatory responsibilities; licensing and enforcement roles would remain but without CON review.
  • Insurers and payers: definitions used for coverage and policy language may change.
  • Patients and communities: changes in where and how new services are established could affect access, pricing, and geographic distribution of services.
  • Local planning and certificate applicants: entities that previously needed to apply for and defend CON applications would no longer undergo that specific review process.

Potential impacts (practical and fiscal)

  • Market effects: repealing CON would lower regulatory barriers for capital projects — potentially accelerating new facility openings, expansions, and provider entry, increasing competition in some areas.
  • Access and distribution: could increase availability of services in higher‑profit areas while leaving some rural/underserved areas at risk if market incentives are weak.
  • Cost and utilization: studies of CON repeal in other jurisdictions show mixed effects; possible upward pressure on utilization and capital investment, and uncertain effects on overall health‑care spending.
  • State fiscal/administrative: reduced CON program workload and associated administrative costs; offsetting effects could include more oversight demands through other licensing/enforcement channels.
  • Legal & transition issues: short‑term litigation and administrative adjustments likely as statutes, licensing protocols, and agency procedures are updated.

Procedural / timeline notes

  • As provided, HB 455 was introduced and has passed its first reading. The bill text shows broad, cross‑statutory repeal/revision language; continuation would require committee hearings, reports, and subsequent readings before final enactment. The bill’s implementation will also require agencies to revise rules, licensing forms, and enforcement guidance if enacted.

For a detailed view, reviewers should consult the bill text and the specific amended code sections (Article 9 of Chapter 131E and the many cross‑referenced sections) to see the precise deletions and conforming edits.

Compiled from official sources — confirm details with the bill’s official record.

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