Senate committee substitute makes the following changes to the 4th edition.

Amends the short and long titles.

Deletes proposed changes made to GS 58-2-70, which added pharmacy benefits manager to the list of individuals for which the civil penalties apply for violations of the provisions of GS Chapter 58 (Insurance).

Enacts new GS 58-56A-10, Civil penalties for violations; administrative procedure, to Article 56A of Chapter 58, which specifically concerns the management of pharmacy benefits, subjecting pharmacy benefits managers to civil penalties for specified violations, if such violations are deemed to be a general business practice. More specifically, provides for the Commissioner of Insurance to assess monetary penalties or petition the Wake County Superior Court for an order of restitution. Specifies that monetary penalties can range from $100 to $1,000 per day per prescription drug for each prescription found to be improperly reimbursed. Allows the Commissioner of Insurance to petition for restitution to the victim or for the reimbursement of Department costs related to the investigation and hearing. Also allows the Commissioner of Insurance to contract with consultants and other professionals for the purposes of such investigations and hearings. Effective July 1, 2016.

Enacts new GS 131E-13(h), concerning the lease or sale of a hospital by a municipality or hospital authority, providing that a municipality or hospital authority can solicit additional, new prospective lessees or buyers if all specified sale requirements have been complied with and after good faith negotiations no lease, sale, or conveyance has been approved. Provides that such solicitation cannot occur before 120 days have passed since the public hearing concerning the transaction was held. Provides that, once new lessees or buyers have been solicited, any lease, sale, or conveyance can be approved without repeating compliance with the initial requirements for such a transaction. Sets out the following four exceptions to approving a transaction without repeating compliance requirements: (1) requiring providing information concerning charges, services, and indigent care at similar facilities currently owned or operated by the proposed lessee or buyer; (2) requiring that the municipality or authority declares its intent to approve the transaction at a meeting held on 10 day's public notice as specified; (3) not approving the transaction until 10 days have passed since the meeting required above; and (4) making the proposed contract available to the public at least 10 days before the above required meeting.

Amends GS 131E-76, the definitions for use in the Hospital Licensure Act, adding and defining existing hospital to mean a hospital that currently or within the last 24 months has (1) held or voluntarily surrendered a hospital license, (2) serves or served patients, (3) is or was staffed, and (4) has or had appropriate equipment. 

Provides that existing hospitals as defined above are deemed operational for the purposes of the Hospital Licensure Act and are exempt from certificate of need review if written notice is received by the Division of Health Service Regulation from the hospital that it will be opening within 36 months of the notice. 

Repeals GS Chapter 90, Article 1E (Certificate of Public Advantage) and GS Chapter 131E, Article 9A (Certificate of Public Advantage). Effective January 1, 2017.