HB 434 North Carolina House · 2025-2026 Session

Lower Healthcare Costs.

HB 434, titled "Lower Healthcare Costs," is a procedural bill focused on updating definitions related to health insurance utilization review in North Carolina. It rewrites statutory definitions (e.g., "medical necessity," "clinical peer," "closely related service") within existing insurance regulations but does not introduce new cost-saving mechanisms or policy changes. The bill directly affects insurers, healthcare providers, and covered individuals by standardizing terminology used in prior authorization processes. As a definition-only update, it has no concrete policy impact on healthcare costs or patient access, and the title does not align with its actual scope.

Bill status failed 4 of 5 stages cleared

Introduction

Mar 2025

Committee Review

Jun 2025

House Passage

Apr 2025

Senate Passage

Jun 2025

Governor

Introduced Mar 18, 2025 Last action Apr 6, 2026

Maddy AI version diff · 2 comparisons

What changed between versions

Edition 1 → Edition 2 · 4 edits

MODERATE

The bill was completely rewritten to shift its focus from administrative 'red tape' reduction to increasing price transparency in healthcare. The new version replaces the old title 'CARE FIRST Act' with 'Lower Healthcare Costs' and updates the legislative text to align with recent federal executive orders on pricing disclosure.

Scope change

The bill's scope changed from updating utilization review rules for insurance claims to establishing a new framework for hospitals and insurers to publicly disclose specific prices for frequently reported medical procedures and hospital stays.

SCOPE

Removed all provisions related to 'red tape' reduction, authorization of interventions, and treatment facilitation.

REQUIREMENT

Added new requirements for hospitals to report prices for the most frequently reported Diagnostic Related Groups (DRGs) and Current Procedural Terminology (CPT) codes on a quarterly basis.

DEFINITION

Replaced definitions related to 'utilization review' and 'chronic conditions' with new definitions for 'Ambulatory surgical facility', 'DRG', 'CPT', and 'Health insurer'.

TIMELINE

Established a new reporting timeline beginning with the period ending September 30, 2015, for submitting price data to the Department of Health and Human Services.

Floor votes · Senate Jun 4, 2025 · House Jun 17, 2025

How they voted

43–3

Passed · 5 other

Total votes 51

Jun 4, 2025

D Democratic20

16 Yea 3 Nay 1

80% Yea

R Republican31

27 Yea 4

87% Yea

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Jun 17, 2025

House · Passed

House Vote: pass (114-0-7)

house

Jun 9, 2025

Committee

Ref To Com On Rules, Calendar, and Operations of the House

lower

Jun 4, 2025

Upper · Passed

Passed 3rd Reading

upper

Jun 3, 2025

Upper · Passed

Reptd Fav

upper

May 22, 2025

Committee

Re-ref Com On Rules and Operations of the Senate

upper

May 22, 2025

Upper · Passed

Com Substitute Adopted

upper

May 22, 2025

Upper · Passed

Reptd Fav Com Substitute

upper

May 19, 2025

Committee

Re-ref to Health Care. If fav, re-ref to Rules and Operations of the Senate

upper

May 1, 2025

Committee

Ref To Com On Rules and Operations of the Senate

upper

Apr 30, 2025

Lower · Passed

Passed 3rd Reading

lower

Apr 28, 2025

Lower · Passed

Reptd Fav

lower

Apr 16, 2025

Committee

Re-ref Com On Rules, Calendar, and Operations of the House

lower

Apr 16, 2025

Lower · Passed

Reptd Fav

lower

Apr 15, 2025

Committee

Re-ref Com On Insurance

lower

Apr 15, 2025

Lower · Passed

Reptd Fav

lower

Mar 19, 2025

Committee

Ref to the Com on Health, if favorable, Insurance, if favorable, Rules, Calendar, and Operations of the House

lower

Mar 18, 2025

Introduced

Filed

lower

3 primary · 57 co-sponsors