Folwell goes on offensive against CONs


One of the biggest reasons Medicaid expansion went nowhere is because of ol’ Roy and his team standing with big hospitals instead of “the little folks” struggling to pay big bills sent out by BIG hospitals.  A provision to weaken existing certificate of need laws was included in the medicaid expansion deal.

Certificates of Need pick and choose who gets to control a certain medical “market” in various regions of North Carolina.  Think you can perform a procedure cheaper and safer than the local big hospital? Sorry.  The big guys already have a Certificate of Need, and the state won’t allow two people in the same area doing the same thing.  CONs are competition-killers that mostly benefit large hospital groups.

Treasurer Dale Folwell has already taken on the hospital lobby and their non-transparent billing practices.  Now, he’s going to court to lend his support to the effort to kill off CONs:

[…] State Treasurer Dale R. Folwell, CPA, sought to become a party to a lawsuit filed in 2020 challenging the state’s Certificate of Need (CON) laws. The lawsuit was filed Dr. Jay Singleton, a New Bern eye surgeon who challenged the state’s CON law that requires him to secure a government issued certificate of need before he can perform most eye surgeries at his vision center. The CON law forces Dr. Singleton to perform most surgeries at New Bern’s Carolina East Medical Center at significantly higher costs to the patient. His lawsuit contends that the CON law violates three sections of the North Carolina Constitution.

North Carolina’s CON law requires that health care providers that want to expand or open facilities in a particular area must first prove to the satisfaction of the North Carolina Department of Health and Human Services that the new or expanded service is needed by the community. Ostensibly, the purpose of CON regulation is to limit spending and cost by discouraging providers from acquiring unnecessary medical equipment. However, studies show CON laws protect incumbent providers from competition rather than protecting patients and payers from unnecessary costs.

Dr. Singleton’s lawsuit was recently dismissed by a unanimous decision of a N.C. Court of Appeals three-judge panel largely on technical grounds. Dr. Singleton then petitioned the court to rehear the case to address the actual issues, but that was denied. Now, Dr. Singleton has filed with the Supreme Court of North Carolina to review his case. On Monday, August 15, 2022, Treasurer Folwell filed an amicus curiae, or “Friend of the Court,” brief in support of Dr. Singleton’s request.

“As ‘keeper of the public purse’ and having responsibility for 750,000 members of the State Health Plan, I felt it was my duty to become part of Dr. Singleton’s lawsuit,” Treasurer Folwell said. “We spend $4 billion a year of taxpayer’s money providing medical and pharmaceutical coverage for those that teach, protect and otherwise serve the people of this state. CON laws are exactly what they sound like – a CON. Every year the hospital cartel, through the North Carolina Healthcare Association, prevents any meaningful change to CON laws. Now, we must go through the courts to achieve that change.”

In the filing, Treasurer Folwell holds the position that CON law violates Article I, Sections 19, 32, and 34 of the North Carolina Constitution. He also notes CON laws create an uneven playing field that protects existing large health care providers. This decreases the accessibility, quality, and affordability of health care while these large hospitals’ profits dramatically increase to the detriment of North Carolinians.” […]