North Carolina lawmakers mull repealing hospital authority boundaries

North Carolina hospitals could soon expand their reach under a proposal that’s being debated in Raleigh as lawmakers finalize a new state budget.

The proposal, included in the state Senate’s two-year spending plan, would repeal a law (known as General Statute 131E-20) that generally limits a hospital authority’s territorial boundary to an area of up to 10 miles from the city or county in which it was created—with some exceptions. That provision would take effect July 1.

If approved as part of the final budget, the proposal would allow health systems, like the Charlotte-Mecklenburg Hospital Authority, which does business as Atrium Health, to expand in the state. Atrium could also fully buy out Winston-Salem-based Wake Forest Baptist Health—with which it merged in October 2020, according to NC Health News.

Critics have argued that the measure could decrease competition among hospitals by giving large systems, like Atrium—which operates healthcare facilities in other states, including Georgia and Alabama—an unfair advantage and lead to more small hospital closures. As a hospital authority, Atrium has eminent domain powers and antitrust protections.

“We oppose the repeal. Consolidation in our medical system harms patients,” the NC Justice Center recently told the Winston-Salem Journal.

Atrium, the state’s largest hospital system, previously backed repealing the law in 2018, arguing that such a move would improve rural health care and allow it to better help patients outside Mecklenburg County, WRAL reported at the time.

A spokesperson for Atrium did not respond to Healthcare Brew’s request for comment on the latest budget proposal.

Lawmakers are expected to finalize the new state budget by July 1—the start of North Carolina’s next fiscal year.