HB 231 establishes North Carolina's participation in the Social Work Interstate Licensure Compact, allowing licensed social workers from participating states to practice across state lines without obtaining separate licenses in each state. The bill directly affects licensed social workers seeking to provide services in multiple states, particularly those serving military families or addressing workforce shortages. Key provisions include mutual recognition of licenses among member states, accountability for social workers practicing where clients are located, and streamlined processes for disciplinary information sharing. This reduces duplicate licensing requirements while maintaining state authority to protect public health and safety through existing licensure systems.
This bill, titled Reagan's Law, aims to improve access to prosthetic and orthotic devices for North Carolinians with limb loss or limb difference by requiring most health benefit plans to cover these devices and related care. Key provisions mandate that plans cover all materials, instruction, and repairs for prosthetics and orthotics, allow for multiple devices based on medical needs, and prohibit denying claims for these devices that would otherwise be covered for non-disabled individuals seeking similar medical treatment. The legislation also requires insurers to provide coverage for device replacements when medically necessary due to changes in the insured's condition or device damage, without limiting coverage based on the device's age or useful lifetime. Additionally, the bill repeals state requirements for health plans to cover emergency care that duplicates federal law, aligning state regulations with federal standards.
House Bill 489 establishes a minimum reimbursement rate for emergency ambulance transportation services provided by out-of-network providers under health benefit plans. It mandates that insurers pay these out-of-network ambulance providers directly and sets a cap on the cost-sharing amounts that insured individuals must pay for these services. The minimum reimbursement rate is determined by local government rates, or if none, by comparing 400% of the Medicare rate to the provider's billed charges. This bill affects individuals needing emergency ambulance services, health insurers, and ambulance service providers, with an effective date of October 1, 2025, for new or renewed insurance contracts.
HB 572 authorizes the Department of Military and Veterans Affairs to establish a statewide pilot program providing Electroencephalogram combined Transcranial Magnetic Stimulation (eTMS) treatment. This program is for veterans, first responders, and their immediate family members experiencing conditions such as substance use disorders, mental illness, sleep disorders, traumatic brain injuries, and PTSD. The Department will select a provider to create a network for in-person and off-site care, aiming for statewide access. Participants in the program will also receive neurophysiological monitoring, counseling, wellness programming, and access to a peer-to-peer support network. The selected provider must collect and report treatment outcomes and expenditures to the Department and legislative committees by September 15, 2026.
This bill, HB 519, revises laws regarding when minors can consent to medical treatment and parental access to their children's medical records. It restricts the medical services a minor can consent to on their own to primarily pregnancy-related care, removing their ability to consent for venereal diseases, substance abuse, or emotional disturbance treatment. The bill also requires written parental consent for minors to receive vaccines authorized for emergency use but not yet fully FDA approved. Additionally, it grants parents the right to access all their minor child's medical records, including those for care the minor could consent to, with exceptions for suspected abuse or neglect, court orders, or active law enforcement investigations.
HB 156 sets minimum standards for stop loss, catastrophic, and reinsurance coverage provided to small employers in North Carolina. It directly affects small employers (defined as those with fewer than 12 eligible employees) and insurers selling these specific insurance products. The bill requires insurers to maintain a minimum annual attachment point of $20,000 per individual (adjusted annually using the Consumer Price Index) and a minimum aggregate attachment point of either 120% of expected claims or $20,000 per year. These standards apply to all new, renewed, or amended insurance contracts issued on or after October 1, 2025.
HB 163 regulates Pharmacy Benefits Managers (PBMs) to ensure fair practices for pharmacies and insured individuals. The bill prohibits PBMs from charging insurers more for a prescription drug than they pay the pharmacy (spread pricing) and requires patient out-of-pocket costs to be based on the net price after any PBM concessions. It establishes minimum reimbursement standards for pharmacies, preventing PBMs from paying less than the national average drug acquisition cost plus a dispensing fee. Additionally, it clarifies that PBMs cannot restrict accredited pharmacies from dispensing specialty drugs and strengthens audit protections for pharmacies.
House Bill 107 designates the second week of November each year as Sudden Unexpected Death in Epilepsy (SUDEP) Awareness Week in North Carolina. Additionally, it encourages local boards of education to develop and offer seizure awareness training for school personnel who are responsible for students with epilepsy or who are otherwise predisposed to seizures. This training aims to provide school staff with information to support these students.
HB 152 aims to regulate how health benefit plans in North Carolina cover Transcranial Magnetic Stimulation (TMS) services. If an insurer chooses to cover TMS, the bill requires them to cover all procedures performed by properly licensed healthcare providers, regardless of their medical specialty, as long as TMS is within their scope of practice. It prohibits insurers from penalizing providers solely based on their specialty when submitting TMS claims. However, the bill maintains that insurers retain discretion over whether to cover TMS, for which conditions, and at what reimbursement rates.
HB 397 allows schools in North Carolina to use epinephrine nasal spray as an emergency treatment option alongside traditional auto-injectors for students experiencing anaphylaxis. The bill amends school health policies to include nasal spray devices in the definition of "epinephrine auto-injector delivery systems," requiring all schools to maintain at least two emergency epinephrine supplies (now including nasal spray) in secure but accessible locations. Schools must train staff to recognize anaphylaxis symptoms, store devices properly, and follow emergency action plans developed with school nurses. This applies to public schools, charter schools, and regional schools starting in the 2025-2026 school year. The policy directly affects school staff, students with severe allergies, and school health protocols.
