HB 351 establishes North Carolina's Recovery-Friendly Workplace Program, which helps employers support employees in addiction recovery. Employers (both public and private) can become "participants" or earn "certified" status by completing training, adopting inclusive policies (like flexible leave and confidential treatment access), and implementing evidence-based practices. The program, funded with $300,000 from the Opioid Settlement Fund, provides employers with advisors, model policies, and annual reviews to maintain certification. It directly affects all North Carolina employers covered by workers' compensation and their employees seeking recovery support. The program becomes effective July 1, 2025.
SB 567 adjusts Medicaid reimbursement rates for substance use disorder (SUD) treatment services in North Carolina. It increases daily rates for outpatient programs (e.g., $255.28 for level 2.1 care) and establishes new coverage for residential treatment levels (e.g., $350/day for level 3.1), with higher rates for medically monitored services like detox ($756.65/day). The bill appropriates $15 million annually from the state General Fund to cover these rate changes, matching $27.4 million in federal funds for the 2025-2027 biennium. These changes directly affect Medicaid-certified SUD treatment providers by increasing their reimbursement rates for specific service levels, effective July 1, 2025.
SB 566 updates North Carolina's health insurance laws to require equal coverage for substance use disorder treatment as for physical health conditions. It replaces outdated terms like "chemical dependency" with "substance use disorder" in state statutes and mandates that medical necessity determinations for addiction treatment must use the same clinical criteria applied to physical health conditions. This directly affects health insurers offering group plans and patients seeking addiction treatment, ensuring they face no stricter coverage limits than for other medical issues. The bill aligns North Carolina's requirements with federal mental health parity law (the Paul Wellstone Act) by explicitly including substance use disorders under coverage parity rules.
SB 464 creates a new team-based care coordination service for Medicaid recipients with substance use disorders, including screening, medication treatment, recovery support, and case management. It also changes Medicaid policy to suspend coverage during incarceration (rather than terminate it), aligning with federal law to maintain access to care upon release. The bill requires the state health department to develop this service, report costs and implementation plans by October 2025, and launch a statewide education campaign for providers. This directly affects Medicaid enrollees with substance use disorders and incarcerated individuals in North Carolina.
SB 759, the Minors Health Protection Act, amends North Carolina law to clarify when minors can consent to specific medical services without parental involvement and when parents can access their minor child's medical records. It allows minors to consent to treatment for venereal diseases, pregnancy, substance abuse, and emotional issues (Section 2(a)), but requires written parental consent for emergency-use vaccines not yet fully FDA-approved (Section 2(a1)). Parents generally have access to all medical records, except for records related to abuse investigations, court orders, or if the parent is under criminal investigation (Section 3(b)). The law takes effect October 1, 2025.
HB 824 aims to expand access to treatment for opioid use disorder and overdose for individuals covered by health benefit plans. It requires health insurers to cover specific healthcare services provided by pharmacists, such as testing and medication administration, if those services are within a pharmacist's scope of practice. The bill also mandates coverage for all FDA-approved prescription drugs for opioid disorder and overdose, prohibiting prior authorization for these medications. Additionally, it updates state laws to ensure mental health benefits in health plans are no less favorable than physical health benefits, aligning with federal requirements.
HB 634 updates North Carolina laws to enhance parity in health insurance coverage for mental health and addiction recovery. It requires all health benefit plans to provide benefits for mental health conditions that are no less favorable than those for physical illnesses, including applying the same financial limits. A key provision mandates that medical necessity determinations for substance use disorders must rely solely on the most recent American Society of Addiction Medicine criteria. The bill also requires the State Health Plan for Teachers and State Employees to comply with these new utilization review standards and updates terminology from "chemical dependency" to "substance use disorder" in relevant statutes.
HB 546 modernizes North Carolina's Medicaid program by requiring the state to develop team-based care coordination for individuals with alcohol and opioid use disorders, including screening, medication, and recovery support. The bill also allows telehealth-only providers to enroll in Medicaid without needing a physical office in the state and mandates a statewide specialty plan for children in foster care or receiving adoption assistance, to be implemented by December 2025. These changes directly affect Medicaid beneficiaries with substance use disorders, telehealth providers, and eligible children and families. The Department of Health and Human Services must report on the implementation of the substance use care and telehealth provisions by October 1, 2025.
HB 562, the Healthcare Investment Act, updates qualification standards for mental health, developmental disabilities, and substance abuse professionals in North Carolina. It allows individuals with an associate degree in human services to qualify as Associate Professionals (with less than two years of experience) or Qualified Professionals (with two years of supervised experience). The bill also creates a new pathway for Qualified Substance Abuse Prevention Professionals (QSAPPs) to qualify with an associate degree and two years of supervised experience in addiction prevention - before completing a bachelor's degree. These changes will expand the pool of eligible professionals for state-funded services under the Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services.
