State Law on Medical Service Expansion Faces Constitutional Challenge
The North Carolina Supreme Court ruled on Friday that a lower court must reconsider the constitutionality of the state’s Certificate of Need (CON) law, which requires health care providers to receive approval from state regulators before expanding services. The decision could have wide-reaching implications for the state’s health care system.
Dr. Jay Singleton, an eye doctor, initiated the legal challenge, arguing that the requirement infringes upon his constitutional rights by preventing him from performing surgeries in his own office without prior approval from health regulators.
Rehearing Ordered by Supreme Court
In a unanimous, unsigned opinion, the state’s highest court directed the case back to a trial court, asserting that previous courts had wrongly treated the lawsuit as one specific to Singleton’s circumstances. Instead, the Supreme Court highlighted that the lawsuit includes “facial challenges” to the law itself, meaning that if proven, the law could be declared unconstitutional across the board.
This ruling could potentially eliminate the CON requirement, which mandates medical entities to seek approval from the North Carolina Department of Health and Human Services before expanding bed space or acquiring expensive equipment. The approval process is meant to assess whether the proposed services are necessary based on factors like population growth and patient demand.
Impact on Health Care Regulations
The case challenges longstanding regulations that many in the health care field argue create unnecessary barriers to expanding services. Republican lawmakers and conservative think tanks have advocated for the repeal or significant reform of the CON law, aiming to introduce more free-market principles into the health care system.
The lawsuit could result in a significant shift in how health care providers can expand their offerings. Should Singleton prevail, the requirement for regulatory approval could be abolished entirely.
Lawsuit Origins and Next Steps
Singleton filed the lawsuit in 2020, claiming that state regulators had prevented him from expanding his New Bern practice to perform more affordable surgeries. State calculations had determined there was no need for additional operating room space in his area, limiting his ability to perform surgeries outside of a local hospital.
The Supreme Court’s ruling vacates a previous 2022 Court of Appeals decision, but no new date has been set for the case to be reheard. Given the facial challenge aspect of the lawsuit, three trial judges may now preside over the case instead of one.
