October 1, 2019

RALEIGH — The John Locke Foundation has filed an amicus brief in Singh v. NCDHHS, the lawsuit filed against the state of North Carolina by Winston-Salem surgeon Dr. Gajendra Singh. The brief was filed in Wake County Superior Court and was written by Jon Guze, JLF’s director of legal studies and a licensed attorney who practiced for 20 years in Durham before joining the foundation.

Dr. Singh contends the state’s Certificate-of-Need (CON) law is unconstitutional and infringes on his right to serve his patients. He is challenging the law related to Magnetic Resonance Imaging machines, or MRIs. CON law requires doctors and hospitals to get permission from the state before they can purchase new equipment and/or expand facilities and offerings. The state, not the doctor or hospital, determines what is ‘needed’ and what is not.

“Not only is the CON law unconstitutional as Dr. Singh asserts, but it directly harms patients and taxpayers by making health care more expensive and less accessible,” Guze said. “Our friend-of-the-court brief responds to the state’s motion to dismiss this case. We show that, contrary to the state’s claims, Dr. Singh has indeed suffered direct injury, and will continue to suffer injury, as a result of the CON law. Each of his constitutional claims is supported by law.”

The brief also provides evidence that CON laws restrict access to health care and increase costs.

In an interview with Carolina Journal Radio from late 2018, Dr. Singh said his patients with serious issues can need multiple scans, and that he could offer MRIs at a lower price than his patients are currently charged. He focuses on liver, pancreatic, and GI surgery and said an MRI is an important part of diagnosis and management.

A hearing in Singh v. NCDHHS is scheduled for the week of Oct. 21 in Wake County Superior Court.

Read the brief here.

Key Takeaways

  • The John Locke Foundation has filed a friend-of-the-court brief in Singh v. NCDHHS, a lawsuit filed against the state by Winston-Salem surgeon Dr. Gajendra Singh, who is challenging the state’s Certificate-of-Need laws related to MRI machines.
  • North Carolina’s Certificate-of-Need (CON) law is unconstitutional, as Dr. Singh claims.
  • Since the Certificate-of-Need law unfairly prohibits Dr. Singh from acquiring an MRI machine and offering scans to his patients, he has been, and will continue to be, injured by the law.
  • Certificate-of-Need laws restrict access to health care and increase costs, as evidence included in the brief shows.


Jon Guze, [email protected], 919-828-3876 or Mitch Kokai, [email protected], 919-306-8736