RALEIGH, N.C. — On Friday, North Carolina’s Supreme Court ordered a reconsideration of a lower court’s examination of the constitutionality of a state law related to health care service expansions.
This law mandates that health regulators must grant approval before new health services can be made available to the public.

The challenge to this legislation, known as the Certificate of Need law, was initiated by Dr. Jay Singleton, an eye surgeon. He contended that the requirement for regulatory approval to perform surgeries in his office infringes on his constitutional rights.

In a unanimous, unsigned opinion, the high court mandated that Singleton’s case be sent back to a trial court for further evaluation.
The justices noted that lower courts had incorrectly interpreted the lawsuit, limiting its context to Singleton’s individual circumstances.

However, the Supreme Court clarified that the lawsuit also includes broader “facial challenges” to the law, which suggest that if these allegations are substantiated, it could lead to the law being deemed unconstitutional in its entirety.
This outcome would abolish the current necessity for medical facilities to seek formal approval from the Department of Health and Human Services whenever they wish to expand their capabilities or acquire expensive new equipment.

The purpose of the agency is to assess the necessity for such services based on factors like population changes and patient needs. Republican lawmakers and conservative think tanks have been advocating for reforms or a complete repeal of the Certificate of Need process, arguing for a more market-driven approach.

The acknowledgment of a facial challenge in Singleton’s lawsuit means that three judges at the trial court level may now oversee the proceedings instead of just one.
Singleton initiated legal action against the state health department along with leaders from the executive and legislative branches in 2020, claiming that state regulators had deemed there was no demand for additional operating room space in his New Bern practice, effectively stifling his ability to provide more affordable surgical options.
Prior to this, he performed the majority of his surgeries at a local hospital.

This recent ruling overturns a 2022 decision made by the Court of Appeals, but it does not establish a timeline for when the case will be heard in court.