House Bill 737 - Preserving Competition in Health Care

• Establishes a new regulatory framework requiring hospital entities to notify the North Carolina Attorney General before consolidating, transferring control, or conveying material assets to non-affiliated entities.

• Mandates a 90-day review period (extendable to 150 days) for the Attorney General to evaluate proposed transactions based on criteria including impact on healthcare cost, availability, accessibility, quality, fair market value, and effects on competition.

• Requires public hearings in affected counties within 14 days of published notice to allow community input; hospitals must disclose transaction details and anticipated financial consideration.

• Authorizes the Attorney General to object to transactions and file legal action seeking injunctive relief or court-ordered modifications; for nonprofit/public hospitals, requires clear and convincing evidence of no fiduciary breach and comparable charitable commitment before approval.

• Imposes post-transaction monitoring for at least 3 years through independent health care access monitors to track effects on healthcare access, pricing, and quality; permits Attorney General to unwind transactions within 10 years if significant anticompetitive harms are demonstrated.