Revises defined terms applicable to certificates of need laws in Article 9, set forth in GS 131E-176, as follows. Changes the threshold criteria for diagnostic center to include a facility, program, or provider in which the total cost of all medical diagnostic equipment used by the facility which cost more than $10,000 or more exceeds $1.5 million (currently, the cost threshold is set at $500,000). Changes the threshold criteria for major medical equipment to include a unit or system used to provide medical or other health services which costs more than $2 million (currently, the threshold is $750,000). Changes the threshold criteria for new institutional health services to include the obligation of capital expenditure exceeding $4 million (was, $2 million) to develop or expand a health service or facility or relates to the provision of health services. Requires the cost threshold amount for diagnostic center, major medical equipment and new institutional health services to be adjusted annually, beginning September 30, 2022, as specified.

Enacts GS 131E-189(d), providing for the expiration of a certificate of need issued for the construction of a health service facility upon the certificate holder failing to initiate authorized construction within: four years after the approval becomes final for projects costing over $50 million; or two years after the approval becomes final for projects costing less than $50 million.

Makes the above provisions effective October 1, 2021.

Includes a severability clause.