The North Carolina Supreme Court's recent ruling on a physician's certificate-of-need lawsuit could lead to an unraveling of the policy, NBC affiliate WRAL reported Oct. 18.
The justices unanimously ruled Oct. 18 to send the suit, filed by an ophthalmologist in New Bern, back to trial with instructions for a much broader trial to determine whether the certificate-of-need system is unconstitutional, according to the report.
"The complaint contains allegations that, if proven, could render the certificate-of-need law unconstitutional in all its applications," the justices wrote in their ruling.
Certificate-of-need laws, which govern where providers can build facilities, have been an obstacle to ASC growth for years. The certificate-of-need process is lengthy and costly, deterring surgeons and organizations in many states from even considering opening ASCs.
Jay Singleton, MD, who owns an ophthalmology practice in New Bern, N.C., alleged in the suit filed April 2020 he can perform only an "incidental" number of surgeries from his center's operating room under current law. He also could not begin the certificate-of-need application process as the state has determined that the community does not need another facility.
He instead performs procedures at a nearby hospital, Carolina East, which charges more per procedure for patients, according to court documents shared with Becker's earlier this year. According to the suit, CarolinaEast charges more than $6,000 per procedure, while Dr. Singleton can provide cataract surgeries for less than $1,800.
North Carolina has made efforts to change the law. In 2023, the state signed legislation exempting "qualified urban ambulatory surgical facilities” from certificate-of-need review, among other changes. Additionally, the North Carolina Senate proposed its budget for the next two fiscal years would drop such requirements in urban areas on the condition that those ASCs meet the Medicaid and self-pay threshold.