GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2025 H 1 HOUSE BILL 522 Short Title: Crisis Pregnancy Center Fraud Prevention Act. (Public) Sponsors: Representatives von Haefen, Butler, and Crawford (Primary Sponsors). For a complete list of sponsors, refer to the North Carolina General Assembly web site. Referred to: Rules, Calendar, and Operations of the House March 27, 2025 *H522 -v-1* A BILL TO BE ENTITLED 1 AN ACT PROVIDING FOR GREATER ACCOUNTABIL ITY OF CRISIS PREGNANCY 2 CENTERS BY DEFINING AS A DECEPTIVE OR UNFAIR PRACTICE THE ACT OF 3 KNOWINGLY ADVERTISIN G THAT ABORTION OR E MERGENCY 4 CONTRACEPTIVE SERVIC ES ARE AVAILABLE WHE N THE PERSON OR ENTITY 5 PUBLISHING THE ADVER TISEMENT DOES NOT PR OVIDE THOSE SERVICES ; 6 AND APPROPRIATING FUNDS TO THE DEPARTMEN T OF HEALTH AND HUMA N 7 SERVICES TO EVALUATE AND REPORT ON CRISI S PREGNANCY CENTERS 8 DOING BUSINESS IN THE STATE. 9 Whereas, in North Carolina, where people have the right to continue a pregnancy or 10 terminate a pregnancy by abortion; and 11 Whereas, pregnant individuals need honest, timely, and accurate information from 12 qualified medical professionals to make informed decisions about their health, well-being, and 13 reproductive healthcare options; and 14 Whereas, according to the American Medical Association's Journal of Ethics, 15 anti-abortion centers, also known as "crisis pregnancy centers," aim "to prevent abortions by 16 persuading people that adoption or parenting is a better option"; and 17 Whereas, anti-abortion centers are the ground-level presence of a well-coordinated 18 anti-abortion movement; and 19 Whereas, anti-abortion centers, with taxpayer dollars diverted to them, greatly 20 outnumber abortion clinics and comprehensive reproductive healthcare centers in our State; and 21 Whereas, anti-abortion centers typically advertise themselves as providers of 22 comprehensive healthcare even though most do not employ licensed medical professionals or 23 provide referrals for emergency contraception or abortion care; and 24 Whereas, low-income patients have been deprived of access to affordable and 25 comprehensive healthcare, including reproductive healthcare, for the last decade while these 26 anti-abortion centers have been receiving taxpayer dollars; and 27 Whereas, many anti-abortion centers use deceptive advertising tactics to target and 28 acquire clients from historically marginalized groups, including Black, Indigenous, and other 29 People of Color; those who live in rural areas; LGBTQ+ communities; young people; students; 30 people with lower incomes; undocumented people; and people for whom English is not their first 31 language; and 32 Whereas, some anti-abortion centers go so far as to advertise so-called "medication 33 abortion reversal," a dangerous and deceptive practice that is not supported by science or clinical 34 standards, according to the American College of Obstetricians and Gynecologists, or by the 35 General Assembly Of North Carolina Session 2025 Page 2 House Bill 522-First Edition United States Food and Drug Administration; and the American Medical Association states, 1 "[Physicians] do not and cannot, without misleading them, tell their patients that it may be 2 possible to reverse a medication abortion"; and 3 Whereas, time is a critical factor for individuals seeking abortion care; and no one 4 should be deceived, manipulated, or face unnecessary delays when seeking support or healthcare 5 during pregnancy, whether they plan to continue a pregnancy or terminate the pregnancy; Now, 6 therefore, 7 The General Assembly of North Carolina enacts: 8 9 PART I. ACCOUNTABILITY FOR DECEPTIVE OR UNFAIR TRADE PRACTICES 10 SECTION 1.1. Chapter 75 of the General Statutes is amended by adding a new 11 section to read: 12 "ยง 75-45. Deceptive representation of healthcare services offered. 13 (a) A person or entity engages in deceptive or unfair practices under this Chapter when 14 the person or entity makes or disseminates an advertisement to the public that indicates the person 15 or entity provides abortions or emergency contraceptives, or provides referrals for abortions or 16 emergency contraceptives, when the person or entity knows or reasonably should know that the 17 person or entity does not provide those services. 18 (b) The learned profession exception of G.S. 75-1.1(b) does not apply to any person or 19 entity that publishes or causes to be published an advertisement that violates subsection (a) of 20 this section, as publishing of that advertisement is a general business dealing and is not a 21 professional service of a learned profession, regardless of whether the person or entity is a 22 healthcare provider licensed under Chapter 90 of the General Statutes. 23 (c) The Attorney General shall accept complaints alleging violations of this section 24 through the North Carolina Department of Justice website. The instructions, guidance, and forms 25 for submitting a complaint for violation of this section shall be able to be comprehended by 26 someone with a fifth grade reading level, accessible to people with disabilities, and the process 27 to submit a complaint shall be designed to be completed by the average internet user in no more 28 than 10 minutes. 29 (d) Before commencing a civil action for a violation of this section, the Attorney General 30 shall send notice to a person or entity that, based upon investigation by the Attorney General, the 31 person or entity is in violation of this section. The person or entity shall have 10 days to correct 32 the violation. If the person or entity has not responded to the notice within 10 days, the Attorney 33 General may initiate civil action against the person or entity. 34 (e) The Attorney General may bring an action to impose civil penalties and to seek other 35 appropriate relief under this Chapter or any other provision of law, including any of the 36 following: 37 (1) Injunctive relief compelling compliance with this section. 38 (2) An order requiring the person or entity to issue corrective advertising in the 39 same mediums and distributed through the same channels as the 40 advertisements in violation of this section. 41 (3) An order requiring the person or entity to post notice inside of the premises of 42 the location advertised for, in a conspicuous place that is visible to all who 43 enter the location or in an examination area or both, any of the following: 44 a. A clear, concise statement that there are or are not any licensed 45 medical doctors, registered nurses, or other licensed medical 46 practitioners on staff at the location. 47 b. A clear, concise statement that the following services are or are not 48 offered at the location: abortion care, emergency contraception, or 49 referrals for abortion or emergency contraception. 50 General Assembly Of North Carolina Session 2025 House Bill 522-First Edition Page 3 (4) Any other narrowly tailored relief that the court deems necessary to remedy 1 the adverse effects of the violation of this section. 2 (f) In addition to any other relief or remedy under this Chapter or other provision of law, 3 in a civil action brought by a person injured by violation of this section, the court shall award to 4 a prevailing plaintiff attorneys' fees and costs, compensatory and punitive damages, and may 5 issue injunctive and declaratory relief. 6 (g) In any action brought for violation of this section, a court may award civil penalties 7 of not less than five hundred dollars ($500.00) and no more than five thousand dollars ($5,000) 8 per violation, the clear proceeds of which shall be paid to the Civil Penalty and Forfeiture Fund 9 in accordance with G.S. 115C-457.2." 10 11 PART II. DEPARTMENT OF HEALTH AND HUMAN SERVICES EVALUATION OF 12 CRISIS PREGNANCY CEN TERS DOING BUSINESS IN THE STATE 13 SECTION 2.1.(a) By May 1, 2026, the Department of Health and Human Services 14 shall evaluate and report to the Joint Legislative Oversight Committee on Health and Human 15 Services and the Fiscal Research Division on the unmet health and resource needs facing 16 pregnant women in North Carolina and the impact of crisis pregnancy centers on the ability of 17 clients to obtain accurate, non-coercive healthcare information and timely access to a 18 comprehensive range of reproductive and sexual healthcare services that aligns with their 19 healthcare needs and supports their personal decision making. In conducting this evaluation, the 20 Department shall examine at least all of the following: 21 (1) The number of crisis pregnancy centers operating in the State that receive 22 State funds, as defined in G.S. 143C-1-1(d)(25), in the form of a grant or direct 23 appropriation. The Department shall compile a list of the names and locations 24 of each crisis pregnancy center examined as a part of this study. 25 (2) The total amount of State funds, federal funds, State and federal tax subsidies, 26 and other subsidies, if any, each crisis pregnancy center identified in 27 subdivision (1) of this subsection received directly or indirectly, over the last 28 five years, broken down by location if the center conducts business or provides 29 services at more than one location. 30 (3) An explanation of whether each crisis pregnancy center is part of a larger 31 umbrella organization that operates within the State and, if so, the total amount 32 of State funds, federal funds, tax subsidies, or other subsidies, if any, the 33 umbrella organization received directly or indirectly over the last five years, 34 broken down by location if the umbrella organization conducts business or 35 provides services at more than one location. 36 (4) An explanation of all services provided by each crisis pregnancy center and 37 which services were most frequently sought, broken down by location if the 38 center conducts business or provides services at more than one location. 39 (5) The number of clients who annually access services at each crisis pregnancy 40 center. 41 (6) Whether crisis pregnancy centers hold themselves out to the public, either in 42 person, through community participation or events, or through their own 43 advertising or websites, as medical facilities or entities that provide 44 comprehensive, all-options pregnancy counseling. 45 (7) Whether clients seeking or accessing services at crisis pregnancy centers are 46 seeking comprehensive, all-options pregnancy counseling or services at 47 medical facilities, and whether clients have experienced a delay in receiving 48 healthcare, including the performance of an abortion or the initiation of 49 prenatal care, due to a visit to a crisis pregnancy center. 50 General Assembly Of North Carolina Session 2025 Page 4 House Bill 522-First Edition (8) Whether crisis pregnancy centers enroll clients in any public benefits 1 programs or connect clients to other services and, if so, a list of these programs 2 and services. 3 (9) The nature of information provided to clients or potential clients at crisis 4 pregnancy centers, and the nature of information included in crisis pregnancy 5 centers' operational manuals, handbooks, or guidelines in connection to the 6 provision of services to clients. 7 (10) The number of State-certified medical professionals on staff or volunteering 8 at each identified crisis pregnancy center, and the number who are providing 9 medical services or counseling on-site during regular business hours, and what 10 information each crisis pregnancy center provides to clients about the 11 presence of medical professionals on the premises, on staff, or serving in a 12 volunteer capacity. 13 (11) Whether crisis pregnancy centers collect medical information and an 14 explanation of what other information is collected upon intake, how crisis 15 pregnancy centers handle medical and other client records, and whether the 16 medical records are in compliance with federal and State laws governing 17 medical privacy. 18 (12) The number of crisis pregnancy centers that have an ultrasound machine on 19 the premises and, if one is present, whether the crisis pregnancy center has a 20 certified ultrasound technician on staff, either as a paid employee or volunteer. 21 SECTION 2.1.(b) As used in this section, the term "crisis pregnancy center" means 22 a nonprofit organization that holds itself out as a healthcare facility that provides care for 23 pregnant women and other clients, such as pregnancy counseling services, pregnancy testing, 24 ultrasound services, and other nonmedical pregnancy services. The term does not include a 25 hospital, ambulatory surgical facility, or clinic that performs abortions. 26 SECTION 2.2. Effective July 1, 2025, there is appropriated from the General Fund 27 to the Department of Health and Human Services the sum of two hundred fifty thousand dollars 28 ($250,000) in nonrecurring funds for the 2025-2026 fiscal year to be used to complete the 29 evaluation and report required by Section 2.1 of this act. The Department of Health and Human 30 Services may use funds appropriated by this section to hire a consultant to assist with completing 31 the evaluation and report. 32 33 PART III. EFFECTIVE DATE 34 SECTION 3.1. Section 1.1 of this act becomes effective October 1, 2025, and applies 35 to advertisements published on or after that date. The remainder of this act is effective when it 36 becomes law. 37