Establishes standards for surgical smoke evacuation in hospitals (new GS 131E-78.4) and ambulatory surgical facilities (new GS 131E-147.2). Requires licensed hospitals and ambulatory surgical facilities to adopt and implement policies that require the use of smoke evacuation/filtering systems during any surgical procedure likely to generate surgical smoke. Defines smoke evacuation/filtering system and surgical smoke. Authorizes the Department of Health and Human Services to take adverse action for violations. Effective January 1, 2026.