SB 239 increases the hourly wage for Direct Support Professionals (DSPs) serving Medicaid beneficiaries under North Carolina's Innovations waiver program by $5 per hour for the 2025-2026 fiscal year and another $5 per hour for 2026-2027. The law requires providers receiving this funding to use at least 90% of the increased payments to raise DSP wages directly, with verification through payroll documentation. The Department of Health and Human Services (DHB) will adjust payments to managed care organizations (LME/MCOs), which must pass the increase to providers and report quarterly on DSP wage changes. This policy directly affects DSPs working with people with intellectual and developmental disabilities (I/DD) and their employers under the waiver program.
House Bill 390, titled "Alleviate the Dangers of Surgical Smoke," establishes new standards for surgical smoke evacuation in North Carolina. This bill requires all licensed hospitals and ambulatory surgical facilities to adopt and implement policies mandating the use of a smoke evacuation/filtering system during surgical procedures likely to generate surgical smoke. A smoke evacuation/filtering system is defined as equipment that captures, filters, and eliminates surgical smoke at its origin. The Department of Health and Human Services is authorized to take adverse action against facilities that violate these new requirements. This act is scheduled to become effective on January 1, 2026.
SB 448 removes two key barriers to Medicaid eligibility for North Carolina workers with disabilities under the "Health Coverage for Workers with Disabilities" program. It eliminates the federal limits on unearned income (like Social Security benefits) and countable assets (savings) that previously disqualified people from maintaining Medicaid coverage while working. The bill requires the state to seek federal CMS approval within 90 days to remove these limits, with implementation effective after CMS approval (targeting a July 2025 effective date). This change directly affects individuals with disabilities who currently face penalties for saving money or receiving certain benefits while enrolled in Medicaid, allowing them to retain healthcare coverage without losing eligibility due to income or asset thresholds. The state will provide $165,000 annually in funding for implementation starting July 2025.
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People with Disabilities
SB 509 revises North Carolina's Statewide Health Information Exchange Act to require certain health care providers serving Medicaid and other state-funded health care programs to connect to the statewide health information exchange network (HIE Network). It overrides the previous voluntary nature of the HIE Network by mandating participation for covered entities providing state-funded care, aiming to improve care coordination and reduce costs through secure electronic sharing of patient data. The bill also adds new civil penalties for violations and introduces a state health data assessment fee. These changes directly affect health care providers, health plans, and facilities receiving state health care funds, with the goal of enhancing data sharing for quality improvement and cost management.
HB 727 modifies the licensure process for marriage and family therapists and therapy associates in North Carolina. It streamlines the process for professionals licensed in other states to obtain a North Carolina license through reciprocity, making it mandatory for qualified applicants. The bill adjusts experience requirements and expands acceptable examination options to include California's clinical examination. Additionally, it clarifies that all applicants, including those applying via reciprocity, must undergo criminal history record checks. These changes aim to facilitate licensing for out-of-state therapists while maintaining regulatory oversight.
HB 565 ("Check Yes, Save Lives") allows North Carolina taxpayers to register as organ donors by checking a box on their state income tax return, starting with tax returns for 2026 and later. This directly affects all North Carolina taxpayers who file income tax returns, providing a simple, automatic way to enroll in the organ donation program during annual tax filing. The bill amends tax and organ donation statutes to add income tax return enrollment as a valid method for making an anatomical gift (under Section 130A-412.7(1a)), while keeping existing options like driver's license or wills. It requires coordination between the Department of Revenue and Motor Vehicles to update the Organ Donor Registry, ensuring the tax-based enrollment is properly recorded. The policy change streamlines donor registration without altering the existing organ donation process or eligibility.
SB 344 ensures that North Carolina seniors aged 65+ who transfer funds into qualifying pooled special needs trusts (meeting federal standards) won't lose Medicaid or State-County Special Assistance eligibility. The bill requires the state health department to update eligibility rules so these transfers are treated as "fair market value" transactions - meaning the funds aren't counted against benefit eligibility if the trust uses the money to provide goods/services equal to the transfer value within the senior's life expectancy. It directly affects seniors using these trusts to manage assets while maintaining public benefits. The law amends state rules to align with federal guidelines (42 U.S.C. § 1396p(d)(4)(C)) and takes effect upon enactment.
HB 555, "Medicaid Telehealth Services," aims to ensure that certain telehealth providers can enroll as Medicaid providers in North Carolina. The bill specifies that individual health care providers licensed by the state who offer services exclusively through telemedicine are not required to maintain a physical presence in the state to be eligible for Medicaid enrollment. Similarly, medical provider groups that exclusively offer telemedicine services will not need an in-state service address to be eligible for the state's Medicaid program. This bill directly affects telehealth providers and medical groups by removing location-based requirements for participating in Medicaid.
HB 229 adjusts North Carolina's Medicaid reimbursement rates for ambulatory surgical centers (ASCs), requiring payments to be at least 95% of the current Medicare Ambulatory Surgical Centers fee schedule. This change directly affects ASCs by increasing their Medicaid payments, with the state appropriating $10.476 million annually from the General Fund to cover the cost and match $19.135 million in federal funds each year for the 2025-2027 fiscal biennium. The bill mandates these rate adjustments to take effect on July 1, 2025, ensuring ASCs receive consistent reimbursement aligned with Medicare rates. The legislation focuses solely on establishing the new payment structure and funding mechanism, without altering eligibility or services.
HB 60 increases Medicaid dental reimbursement rates from 35% to 46% of average dentist charges (2023 rates) to align with neighboring states. The bill allocates $52 million annually from North Carolina's General Fund, matched by $95 million in federal funds, to cover this rate increase starting July 1, 2025. It directly affects dentists who accept Medicaid patients and Medicaid beneficiaries seeking dental care, aiming to boost provider participation and prevent costly emergency treatments. The change addresses years of stagnant rates that reduced dental provider enrollment in Medicaid.
