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North Carolina
Find more information about Community Catalyst projects in North Carolina.
OVERVIEW: There are no formal requirements governing the provision of free care in North Carolina. The counties—specifically, the county directors of Social Services—are charged with overseeing the care of indigent persons within their borders, but it does not appear that this obligation extends to include the provision of financial assistance or free care to those who are unable to pay. See N.C. Gen. Stat. §§ 108A-14; 153A-255.
CITATION:
Certificate of Need
North Carolina General Statutes §§ 131E-175 to 131E-192
TERMINOLOGY:
Indigent care
Medically indigent
REGULATORY OVERSIGHT:
The Department of Health and Human Services oversees the Certificate of Need process. N.C. Gen. Stat. § 131E-177.
DEFINITIONS AND DISTINCTIONS: N/A
FREE CARE AS A COMMUNITY BENEFIT: N/A
ELIGIBILITY REQUIREMENTS: N/A
FINANCING SOURCE: N/A
SERVICES COVERED: N/A
NOTIFICATION REQUIREMENTS: N/A
APPLICATION PROCESS: N/A
GRIEVANCE/APPEAL PROCESS: N/A
REPORTING REQUIREMENTS: N/A
PENALTIES FOR NONCOMPLIANCE: N/A
OTHER:
Certificate of Need requirements. Any entity attempting to offer or develop a “new institutional health service” must obtain a Certificate of Need (hereinafter “CON”) from the Department of Health and Human Services. In order to obtain a CON, an applicant must include a “commitment and plan for serving indigent and medically underserved populations.” N.C. Gen. Stat. §131E-178(a). Among other things, the CON application shall demonstrate how the proposed new service will meet the needs of the “medically underserved,” including low-income and medically indigent persons. N.C. Gen. Stat. § 131E-183(13). In order to demonstrate how the new service will be accessible to these populations, the CON applicant shall show how it has met any uncompensated care obligations set forth in regulation. Id. To date, however, no such obligations appear to exist.
Conversions. When a municipality or hospital authority leases, sells, or otherwise conveys a hospital facility to a for-profit or nonprofit corporation, the new corporation must ensure that indigent care is available to the population of the municipality served by the hospital. N.C. Gen. Stat. § 131E-13(a). The municipality must review the corporation’s record on charges, services, and indigent care at similar facilities owned by the corporation before entering into an agreement. Id. Indigent care must be provided at a level related to the community’s need, as determined by the municipality or hospital authority. Id. The acquiring corporation must prepare an annual report demonstrating that it has fulfilled these obligations. Id.
Financial Aid for Individuals with Cancer. The Department of Health and Human Services shall provide financial assistance to indigent North Carolina citizens having or suspected of having cancer. N.C. Gen. Stat. § 130A-206.
