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North Carolina House Bill H455

North Carolina 2025-2026 Regular Session

North Carolina House Bill H455 Compare Versions

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11 GENERAL ASSEMBLY OF NORTH CAROLINA
22 SESSION 2025
3-H 1
4-HOUSE BILL 455
3+H D
4+HOUSE BILL DRH30001-MG-6
5+
56
67
78 Short Title: Repeal Certificate of Need Laws. (Public)
8-Sponsors: Representatives Kidwell, Ward, and Pike (Primary Sponsors).
9-For a complete list of sponsors, refer to the North Carolina General Assembly web site.
10-Referred to: Rules, Calendar, and Operations of the House
11-March 20, 2025
12-*H455 -v-1*
9+Sponsors: Representative Kidwell.
10+Referred to:
11+
12+*DRH30001 -MG-6*
1313 A BILL TO BE ENTITLED 1
1414 AN ACT REPEALING NORTH CAROLINA 'S CERTIFICATE OF NEED LAWS. 2
1515 The General Assembly of North Carolina enacts: 3
1616 SECTION 1.(a) G.S. 6-19.1(a) reads as rewritten: 4
1717 "(a) In any civil action, other than an adjudication for the purpose of establishing or fixing 5
1818 a rate, or a disciplinary action by a licensing board, brought by the State or brought by a party 6
1919 who is contesting State action pursuant to G.S. 150B-43 or any other appropriate provisions of 7
2020 law, unless the prevailing party is the State, the court may, in its discretion, allow the prevailing 8
2121 party to recover reasonable attorney's fees, including attorney's fees applicable to the 9
2222 administrative review portion of the case, in contested cases arising under Article 3 of Chapter 10
2323 150B, to be taxed as court costs against the appropriate agency if: 11
2424 (1) The court finds that the agency acted without substantial justification in 12
2525 pressing its claim against the party; and 13
2626 (2) The court finds that there are no special circumstances that would make the 14
2727 award of attorney's fees unjust. The party shall petition for the attorney's fees 15
2828 within 30 days following final disposition of the case. The petition shall be 16
2929 supported by an affidavit setting forth the basis for the request. 17
3030 Nothing in this section shall be deemed to authorize the assessment of attorney's fees for the 18
3131 administrative review portion of the case in contested cases arising under Article 9 of Chapter 19
3232 131E of the General Statutes. 20
3333 Nothing in this section grants permission to bring an action against an agency otherwise 21
3434 immune from suit or gives a right to bring an action to a party who otherwise lacks standing to 22
3535 bring the action. 23
3636 Any attorney's fees assessed against an agency under this section shall be charged against the 24
3737 operating expenses of the agency and shall not be reimbursed from any other source." 25
3838 SECTION 1.(b) Subsection (a) of this section applies to contested cases arising on 26
3939 or after January 1, 2026. 27
4040 SECTION 2.(a) G.S. 7A-29(a) reads as rewritten: 28
4141 "(a) From any final order or decision of the North Carolina Utilities Commission not 29
4242 governed by subsection (b) of this section, the Department of Health and Human Services under 30
4343 G.S. 131E-188(b), the North Carolina Industrial Commission, the North Carolina State Bar under 31
4444 G.S. 84-28, the Property Tax Commission under G.S. 105-290 and G.S. 105-342, the 32
4545 Commissioner of Insurance under G.S. 58-2-80, the State Board of Elections under 33
46-G.S. 163-127.6, the Office of Administrative Hearings under G.S. 126-34.02, or the Secretary of 34 General Assembly Of North Carolina Session 2025
47-Page 2 House Bill 455-First Edition
48-Environmental Quality under G.S. 104E-6.2 or G.S. 130A-293, appeal as of right lies directly to 1
49-the Court of Appeals." 2
50-SECTION 2.(b) Subsection (a) of this section applies to appeals arising on or after 3
51-January 1, 2026. 4
52-SECTION 3. G.S. 58-50-61(a) reads as rewritten: 5
53-"(a) Definitions. – As used in this section, in G.S. 58-50-62, and in Part 4 of this Article, 6
54-the term: 7
55-… 8
56-(7a) "Health care facility" means a hospital; long-term care hospital; psychiatric 9
57-facility; rehabilitation facility; nursing home facility; adult care home; kidney 10
58-disease treatment center, including freestanding hemodialysis units; 11
59-intermediate care facility for individuals with intellectual disabilities; home 12
60-health agency office; chemical dependency treatment facility; diagnostic 13
61-center; hospice office, hospice inpatient facility, or hospice residential care 14
62-facility; or ambulatory surgical facility. 15
63-(8) "Health care provider" means any person who is licensed, registered, or 16
64-certified under Chapter 90 of the General Statutes or the laws of another state 17
65-to provide health care services in the ordinary care of business or practice or 18
66-a profession or in an approved education or training program; a health care 19
67-facility as defined in G.S. 131E-176(9b) this section or the laws of another 20
68-state to operate as a health care facility; or a pharmacy. 21
69-…." 22
70-SECTION 4. G.S. 58-55-35(a) reads as rewritten: 23
71-"(a) Whenever long-term care insurance provides coverage for the facilities, services, or 24
72-physical or mental conditions listed below, unless otherwise defined in the policy and certificate, 25
73-and approved by the Commissioner, the facilities, services, or conditions have the following 26
74-definitions: 27
75-… 28
76-(10) Hospice. – As defined in G.S. 131E-176(13a).Any coordinated program of 29
77-home care with provision for inpatient care for terminally ill patients and their 30
78-families. This care is provided by a medically directed interdisciplinary team 31
79-directly or through an agreement under the direction of an identifiable hospice 32
80-administration. A hospice program of care provides palliative and supportive 33
81-medical and other health services to meet the physical, psychological, social, 34
82-spiritual, and special needs of patients and their families, which are 35
83-experienced during the final stages of terminal illness and during dying and 36
84-bereavement. 37
85-(11) Intermediate care facility for individuals with intellectual disabilities. – As 38
86-defined in G.S. 131E-176(14a).Facilities licensed pursuant to Article 2 of 39
87-Chapter 122C of the General Statutes for the purpose of providing health and 40
88-habilitative services based on the developmental model and principles of 41
89-normalization for individuals with intellectual disabilities, autism, cerebral 42
90-palsy, epilepsy, or related conditions. 43
91-…." 44
92-SECTION 5. G.S. 90-21.82A(a) reads as rewritten: 45
93-"(a) The following definitions apply in this section: 46
94-(1) Abortion clinic. – As defined in G.S. 131E-153.1. 47
95-(2) Ambulatory surgical facility. – As defined in G.S. 131E-176.A facility 48
96-licensed under Part 4 of Article 6 of Chapter 131E of the General Statutes. 49
97-(3) Hospital. – As defined in G.S. 131E-176.A facility licensed under Article 5 of 50
98-Chapter 131E of the General Statutes." 51 General Assembly Of North Carolina Session 2025
99-House Bill 455-First Edition Page 3
100-SECTION 6. G.S. 90-414.4(a1)(1) reads as rewritten: 1
101-"(1) The following providers of Medicaid services licensed to operate in the State 2
102-that have an electronic health record system shall begin submitting, at a 3
103-minimum, demographic and clinical data by June 1, 2018: 4
104-a. Hospitals as defined in G.S. 131E-176(13).Hospitals, defined for the 5
105-purposes of this section as public or private institutions which are 6
106-primarily engaged in providing to inpatients, by or under supervision 7
107-of physicians, diagnostic services and therapeutic services for medical 8
108-diagnosis, treatment, and care of injured, disabled, or sick persons, or 9
109-rehabilitation services for the rehabilitation of injured, disabled, or 10
110-sick persons. The term includes all facilities licensed pursuant to 11
111-G.S. 131E-77, except long-term care hospitals. 12
112-b. Physicians licensed to practice under Article 1 of Chapter 90 of the 13
113-General Statutes, except for licensed physicians whose primary area 14
114-of practice is psychiatry. 15
115-c. Physician assistants as defined in 21 NCAC 32S.0201.21 NCAC 32S 16
116-.0201. 17
117-d. Nurse practitioners as defined in 21 NCAC 36.0801.21 NCAC 36 18
118-.0801." 19
119-SECTION 7. G.S. 90-414.4(b)(1) reads as rewritten: 20
120-"(1) Each hospital, as defined in G.S. 131E-176(13) that has an electronic health 21
121-record system.hospital." 22
122-SECTION 8. G.S. 113A-12(3)e. reads as rewritten: 23
123-"e. A health care facility financed pursuant to Article 1 of Chapter 131A 24
124-of the General Statutes or receiving a certificate of need under Article 25
125-9 of Chapter 131E of the General Statutes." 26
126-SECTION 9. G.S. 122C-23.1(e) reads as rewritten: 27
127-"(e) As used in this section, "residential treatment facility" means a "residential facility" 28
128-as defined in and licensed under this Chapter, but not subject to Certificate of Need requirements 29
129-under Article 9 of Chapter 131E of the General Statutes.Chapter." 30
130-SECTION 10. G.S. 131D-2.4(a) reads as rewritten: 31
131-"(a) Licensure. – Except for those facilities exempt under G.S. 131D-2.3, the Department 32
132-of Health and Human Services shall inspect and license all adult care homes. The Department 33
133-shall issue a license for a facility not currently licensed as an adult care home for a period of six 34
134-months. If the licensee demonstrates substantial compliance with Articles 1 and 3 of this Chapter 35
135-and rules adopted thereunder, the Department shall issue a license for the balance of the calendar 36
136-year. A facility not currently licensed as an adult care home that was licensed as an adult care 37
137-home within the preceding 12 months is considered an existing health service facility for the 38
138-purposes of G.S. 131E-184(a)(8)." 39
139-SECTION 11. G.S. 131E-13(a)(1) reads as rewritten: 40
140-"(1) The corporation shall continue to provide the same or similar clinical hospital 41
141-services to its patients in medical-surgery, obstetrics, pediatrics, outpatient 42
142-and emergency treatment, including emergency services for the indigent, that 43
143-the hospital facility provided prior to the lease, sale, or conveyance. These 44
144-services may be terminated only as prescribed by Certificate of Need Law 45
145-prescribed in Article 9 of Chapter 131E of the General Statutes, or, if 46
146-Certificate of Need Law is inapplicable, by review procedure designed to 47
147-guarantee public participation pursuant to rules adopted by the Secretary of 48
148-the Department of Health and Human Services." 49
149-SECTION 12. G.S. 131E-84(a1) reads as rewritten: 50 General Assembly Of North Carolina Session 2025
150-Page 4 House Bill 455-First Edition
151-"(a1) In the event of a declaration of a state of emergency by the Governor in accordance 1
152-with Article 1A of Chapter 166A of the General Statutes, a declaration of a national emergency 2
153-by the President of the United States, a declaration of a public health emergency by the Secretary 3
154-of the United States Department of Health and Human Services; or to the extent necessary to 4
155-allow for consistency with any temporary waiver or modification issued by the Secretary of the 5
156-United States Department of Health and Human Services or the Centers for Medicare and 6
157-Medicaid Services under section 1135 or 1812(f) of the Social Security Act; or when the Division 7
158-of Health Service Regulation determines the existence of an emergency that poses a risk to the 8
159-health or safety of patients, the Division of Health Service Regulation may do either or both of 9
160-the following: 10
161-(1) Temporarily temporarily waive any rules of the Commission pertaining to 11
162-hospitals. 12
163-(2) Notwithstanding G.S. 131E-183, allow a hospital to temporarily increase its 13
164-bed capacity." 14
165-SECTION 13. G.S. 131E-136(4) reads as rewritten: 15
166-"(4) "Home health agency" means a home care agency which is certified to receive 16
167-Medicare and Medicaid reimbursement for providing nursing care, therapy, 17
168-medical social services, and home health aide services on a part-time, 18
169-intermittent basis as set out in G.S. 131E-176(12), and is thereby also subject 19
170-to Article 9 of Chapter 131E.basis." 20
171-SECTION 14. The following laws are repealed: 21
172-(1) Article 9 of Chapter 131E of the General Statutes. 22
173-(2) G.S. 130A-45.02(i). 23
174-(3) G.S. 131E-78.3(c). 24
175-(4) G.S. 131E-146(3), as enacted by Section 3.2(b) of S.L. 2023-7. 25
176-(5) G.S. 131E-147.5, as enacted by Section 3.2(c) of S.L. 2023-7. 26
177-(6) G.S. 143B-1292. 27
178-(7) G.S. 150B-2(8a)k. 28
179-(8) G.S. 150B-21.1(a)(6). 29
180-SECTION 15. This act becomes effective January 1, 2026. 30
46+G.S. 163-127.6, the Office of Administrative Hearings under G.S. 126-34.02, or the Secretary of 34
47+Environmental Quality under G.S. 104E-6.2 or G.S. 130A-293, appeal as of right lies directly to 35
48+the Court of Appeals." 36
49+H.B. 455
50+Mar 18, 2025
51+HOUSE PRINCIPAL CLERK General Assembly Of North Carolina Session 2025
52+Page 2 DRH30001-MG-6
53+SECTION 2.(b) Subsection (a) of this section applies to appeals arising on or after 1
54+January 1, 2026. 2
55+SECTION 3. G.S. 58-50-61(a) reads as rewritten: 3
56+"(a) Definitions. – As used in this section, in G.S. 58-50-62, and in Part 4 of this Article, 4
57+the term: 5
58+… 6
59+(7a) "Health care facility" means a hospital; long-term care hospital; psychiatric 7
60+facility; rehabilitation facility; nursing home facility; adult care home; kidney 8
61+disease treatment center, including freestanding hemodialysis units; 9
62+intermediate care facility for individuals with intellectual disabilities; home 10
63+health agency office; chemical dependency treatment facility; diagnostic 11
64+center; hospice office, hospice inpatient facility, or hospice residential care 12
65+facility; or ambulatory surgical facility. 13
66+(8) "Health care provider" means any person who is licensed, registered, or 14
67+certified under Chapter 90 of the General Statutes or the laws of another state 15
68+to provide health care services in the ordinary care of business or practice or 16
69+a profession or in an approved education or training program; a health care 17
70+facility as defined in G.S. 131E-176(9b) this section or the laws of another 18
71+state to operate as a health care facility; or a pharmacy. 19
72+…." 20
73+SECTION 4. G.S. 58-55-35(a) reads as rewritten: 21
74+"(a) Whenever long-term care insurance provides coverage for the facilities, services, or 22
75+physical or mental conditions listed below, unless otherwise defined in the policy and certificate, 23
76+and approved by the Commissioner, the facilities, services, or conditions have the following 24
77+definitions: 25
78+… 26
79+(10) Hospice. – As defined in G.S. 131E-176(13a).Any coordinated program of 27
80+home care with provision for inpatient care for terminally ill patients and their 28
81+families. This care is provided by a medically directed interdisciplinary team 29
82+directly or through an agreement under the direction of an identifiable hospice 30
83+administration. A hospice program of care provides palliative and supportive 31
84+medical and other health services to meet the physical, psychological, social, 32
85+spiritual, and special needs of patients and their families, which are 33
86+experienced during the final stages of terminal illness and during dying and 34
87+bereavement. 35
88+(11) Intermediate care facility for individuals with intellectual disabilities. – As 36
89+defined in G.S. 131E-176(14a).Facilities licensed pursuant to Article 2 of 37
90+Chapter 122C of the General Statutes for the purpose of providing health and 38
91+habilitative services based on the developmental model and principles of 39
92+normalization for individuals with intellectual disabilities, autism, cerebral 40
93+palsy, epilepsy, or related conditions. 41
94+…." 42
95+SECTION 5. G.S. 90-21.82A(a) reads as rewritten: 43
96+"(a) The following definitions apply in this section: 44
97+(1) Abortion clinic. – As defined in G.S. 131E-153.1. 45
98+(2) Ambulatory surgical facility. – As defined in G.S. 131E-176.A facility 46
99+licensed under Part 4 of Article 6 of Chapter 131E of the General Statutes. 47
100+(3) Hospital. – As defined in G.S. 131E-176.A facility licensed under Article 5 of 48
101+Chapter 131E of the General Statutes." 49
102+SECTION 6. G.S. 90-414.4(a1)(1) reads as rewritten: 50 General Assembly Of North Carolina Session 2025
103+DRH30001-MG-6 Page 3
104+"(1) The following providers of Medicaid services licensed to operate in the State 1
105+that have an electronic health record system shall begin submitting, at a 2
106+minimum, demographic and clinical data by June 1, 2018: 3
107+a. Hospitals as defined in G.S. 131E-176(13).Hospitals, defined for the 4
108+purposes of this section as public or private institutions which are 5
109+primarily engaged in providing to inpatients, by or under supervision 6
110+of physicians, diagnostic services and therapeutic services for medical 7
111+diagnosis, treatment, and care of injured, disabled, or sick persons, or 8
112+rehabilitation services for the rehabilitation of injured, disabled, or 9
113+sick persons. The term includes all facilities licensed pursuant to 10
114+G.S. 131E-77, except long-term care hospitals. 11
115+b. Physicians licensed to practice under Article 1 of Chapter 90 of the 12
116+General Statutes, except for licensed physicians whose primary area 13
117+of practice is psychiatry. 14
118+c. Physician assistants as defined in 21 NCAC 32S.0201.21 NCAC 32S 15
119+.0201. 16
120+d. Nurse practitioners as defined in 21 NCAC 36.0801.21 NCAC 36 17
121+.0801." 18
122+SECTION 7. G.S. 90-414.4(b)(1) reads as rewritten: 19
123+"(1) Each hospital, as defined in G.S. 131E-176(13) that has an electronic health 20
124+record system.hospital." 21
125+SECTION 8. G.S. 113A-12(3)e. reads as rewritten: 22
126+"e. A health care facility financed pursuant to Article 1 of Chapter 131A 23
127+of the General Statutes or receiving a certificate of need under Article 24
128+9 of Chapter 131E of the General Statutes." 25
129+SECTION 9. G.S. 122C-23.1(e) reads as rewritten: 26
130+"(e) As used in this section, "residential treatment facility" means a "residential facility" 27
131+as defined in and licensed under this Chapter, but not subject to Certificate of Need requirements 28
132+under Article 9 of Chapter 131E of the General Statutes.Chapter." 29
133+SECTION 10. G.S. 131D-2.4(a) reads as rewritten: 30
134+"(a) Licensure. – Except for those facilities exempt under G.S. 131D-2.3, the Department 31
135+of Health and Human Services shall inspect and license all adult care homes. The Department 32
136+shall issue a license for a facility not currently licensed as an adult care home for a period of six 33
137+months. If the licensee demonstrates substantial compliance with Articles 1 and 3 of this Chapter 34
138+and rules adopted thereunder, the Department shall issue a license for the balance of the calendar 35
139+year. A facility not currently licensed as an adult care home that was licensed as an adult care 36
140+home within the preceding 12 months is considered an existing health service facility for the 37
141+purposes of G.S. 131E-184(a)(8)." 38
142+SECTION 11. G.S. 131E-13(a)(1) reads as rewritten: 39
143+"(1) The corporation shall continue to provide the same or similar clinical hospital 40
144+services to its patients in medical-surgery, obstetrics, pediatrics, outpatient 41
145+and emergency treatment, including emergency services for the indigent, that 42
146+the hospital facility provided prior to the lease, sale, or conveyance. These 43
147+services may be terminated only as prescribed by Certificate of Need Law 44
148+prescribed in Article 9 of Chapter 131E of the General Statutes, or, if 45
149+Certificate of Need Law is inapplicable, by review procedure designed to 46
150+guarantee public participation pursuant to rules adopted by the Secretary of 47
151+the Department of Health and Human Services." 48
152+SECTION 12. G.S. 131E-84(a1) reads as rewritten: 49
153+"(a1) In the event of a declaration of a state of emergency by the Governor in accordance 50
154+with Article 1A of Chapter 166A of the General Statutes, a declaration of a national emergency 51 General Assembly Of North Carolina Session 2025
155+Page 4 DRH30001-MG-6
156+by the President of the United States, a declaration of a public health emergency by the Secretary 1
157+of the United States Department of Health and Human Services; or to the extent necessary to 2
158+allow for consistency with any temporary waiver or modification issued by the Secretary of the 3
159+United States Department of Health and Human Services or the Centers for Medicare and 4
160+Medicaid Services under section 1135 or 1812(f) of the Social Security Act; or when the Division 5
161+of Health Service Regulation determines the existence of an emergency that poses a risk to the 6
162+health or safety of patients, the Division of Health Service Regulation may do either or both of 7
163+the following: 8
164+(1) Temporarily temporarily waive any rules of the Commission pertaining to 9
165+hospitals. 10
166+(2) Notwithstanding G.S. 131E-183, allow a hospital to temporarily increase its 11
167+bed capacity." 12
168+SECTION 13. G.S. 131E-136(4) reads as rewritten: 13
169+"(4) "Home health agency" means a home care agency which is certified to receive 14
170+Medicare and Medicaid reimbursement for providing nursing care, therapy, 15
171+medical social services, and home health aide services on a part-time, 16
172+intermittent basis as set out in G.S. 131E-176(12), and is thereby also subject 17
173+to Article 9 of Chapter 131E.basis." 18
174+SECTION 14. The following laws are repealed: 19
175+(1) Article 9 of Chapter 131E of the General Statutes. 20
176+(2) G.S. 130A-45.02(i). 21
177+(3) G.S. 131E-78.3(c). 22
178+(4) G.S. 131E-146(3), as enacted by Section 3.2(b) of S.L. 2023-7. 23
179+(5) G.S. 131E-147.5, as enacted by Section 3.2(c) of S.L. 2023-7. 24
180+(6) G.S. 143B-1292. 25
181+(7) G.S. 150B-2(8a)k. 26
182+(8) G.S. 150B-21.1(a)(6). 27
183+SECTION 15. This act becomes effective January 1, 2026. 28