A North Carolina physician, Dr. Gajendra Singh, has filed a legal action against the state's Department of Health and Human Services challenging the constitutionality of the certificate of need requirement. Dr. Singh seeks to overturn the North Carolina law requiring him to obtain a certificate of need before purchasing an MRI scanner. He claims the law is unconstitutional because its purpose is solely to protect existing providers from competition.

A state superior court judge has denied the Department's motion to dismiss the case, ruling that it is not necessary to go through a statutorily required process to challenge it. According to Dr. Singh's attorneys, the North Carolina Constitution specifically outlaws state-enforced monopolies and requires that laws be applied evenly to protect citizens' right to pursue their chosen businesses.

The case is being handled by the Institute for Justice, a non-profit, libertarian, public interest law firm.