Establishes standards for surgical smoke evacuation in hospitals (new GS 131E-78.4) and ambulatory surgical facilities (new GS 131E-147.2). Requires licensed hospitals and ambulatory surgical facilities to adopt and implement policies that require the use of smoke evacuation systems during any surgical procedure likely to generate surgical smoke. Defines smoke evacuation system and surgical smoke. Authorizes the Department of Health and Human Services to take adverse action for violations. Effective January 1, 2024.