Bill
SB 1040
repeals certificate of need for ambulatory surgical facilities and inpatient rehabilitation beds, enabling faster establishment and expansion while maintaining other licensing cont
Proposed by: Senators Lee, Sawrey, and Burgin
Date Filed: April 30, 2026
Purpose and intent
- The bill seeks to repeal North Carolina’s certificate of need (CON) requirements specifically for:
- Ambulatory surgical facilities (ASCs), including professional programs and facilities for same-day surgeries.
- Inpatient rehabilitation services, facilities, and beds.
- It appropriates funds to the Department of Health and Human Services (DHHS) to implement the repeal and to develop a plan for phasing out the remaining CON laws in the state.
- It also repeals certain obsolete definitions related to behavioral health facilities that are no longer subject to CON review.
Key provisions and changes
1) Repeal of CON for ASCs and inpatient rehabilitation
- Sections 1 and 2 repeal CON review for:
- Ambulatory surgical facilities (ASCs) and the ambulatory surgical programs operating within or across facilities.
- Inpatient rehabilitation facilities and beds (as part of health service facilities).
- The repeal explicitly targets CON review processes tied to establishing or expanding these services and beds.
2) Definitions and terminology updates
- The act rewrites various definitions within G.S. 131E-176 to reflect the new CON regime for ASCs and rehabilitation services, including:
- Definitions of ambulatory surgical facility, ambulatory surgical program, multispecialty and specialty ambulatory surgical programs.
- Definitions relevant to health service facilities and beds (e.g., rehabilitation facility, hospital, qualified urban ASC).
- It removes certain terms and definitions that were tied to CON requirements for behavioral health facilities.
3) Elimination of CON requirement for certain license pathways
- The bill preserves a pathway whereby:
- Gastrointestinal endoscopy facilities in nonlicensed settings can convert to licensed ASCs with a set of compliance checks, but only for certain endoscopy facilities; otherwise, CON is still required for establishing new ASCs for GI endoscopy.
- It states that the state medical facilities plan should not limit the number of GI endoscopy rooms under the specified transition.
4) Appropriations and planning for phased CON elimination
- Section 5 authorizes a one-time, nonrecurring appropriation of $50,000 from the General Fund to DHHS (Division of Health Service Regulation) for the 2026-2027 fiscal year.
- Use of funds:
- Implement the CON repeal for ASCs and inpatient rehab facilities/beds.
- Develop a comprehensive plan for phasing out the remaining CON laws in North Carolina.
- Plan requirements:
- The plan must propose a three-year phaseout timeline and include a detailed schedule for phasing out specific health services and facilities.
- DHHS must submit the plan to: Joint Legislative Oversight Committee on Health and Human Services, chairs of relevant Appropriations committees, Speaker of the House, President Pro Tempore of the Senate, and the Fiscal Research Division, by July 1, 2027.
Effective date
- The act becomes effective July 1, 2026.
Severability
- Provisions are severable; if any part is invalid, the rest remains in effect as long as it can operate independently.
Potential impact and considerations
For health care providers:
For patients and access to care:
For policymakers and regulators:
If you’d like, I can tailor this summary to a specific audience (e.g., policymakers, health administrators, or the public), or add a side-by-side comparison showing CON status before and after the bill.
Compiled from official sources — confirm details with the bill’s official record.
Sign in to ask a question.
