Amends GS 131E-20 to provide as title indicates (currently, the territorial boundaries include the city or county creating the hospital authority and the area within 10 miles). Specifies that if a hospital authority enters into an agreement to engage in health care activities in a county outside the authority’s territorial boundaries under (1) an agreement with a hospital facility in only one hospital currently exists in that county; (2) an agreement with any hospital if more than one hospital currently exists in that county; or (3) an agreement with any health care agency if no hospital currently exists in that county, then the hospital authority must first apply for an obtain a certificate or public advantage.