Certificate of need changes in the Carolinas: What ASCs need to know in 2023

Certificate of need laws could change drastically in North and South Carolina in the next year, according to a Jan. 11 article in JDSupra from the law firm Nexsen Pruet. 

The South Carolina Department of Health and Environmental Control has proposed to increase the threshold for capital expenditures that require a certificate of need to more than $5 million and the threshold for equipment acquisitions that require a CON to more than $2 million. Additionally, these thresholds will be indexed to account for inflation. These amendments now await the South Carolina General Assembly to take action. 

In South Carolina's last legislative session, the Senate passed a bill that would have repealed the CON law, but it died in the House.

"We expect there to be another attempt to rescind or significantly modify the CON program in 2023," the report reads. 

In 2021 in North Carolina, the state increased the CON capital threshold from $2 million to $4 million and increased the threshold for equipment acquisitions that require a CON from $750,000 to $2 million, as well as indexing for inflation. 

In August, the North Carolina Treasurer filed an amicus brief challenging the legality of the state's CON laws. According to the report, if government officials continue to raise concerns over their state's law, "It is possible that 2023 could turn into a crucial year of legislative debate over the future of the program as a whole."

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