Healthcare (Insurance)

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 297, titled "Breast Cancer Prevention Imaging Parity," aims to ensure equal health insurance coverage for different types of breast cancer imaging. The bill mandates that health benefit plans apply the same cost-sharing requirements (like deductibles and copayments) for diagnostic and supplemental breast examinations, such as MRIs and ultrasounds, as they do for routine screening mammograms. This ensures individuals needing these additional medically necessary tests do not face higher out-of-pocket costs compared to standard screenings. It also maintains existing coverage for cervical cancer screenings and includes provisions for high-deductible health plans.

HB 576 makes technical revisions to North Carolina's laws governing the Department of Health and Human Services (DHHS). It designates DHHS as the agency managing school nurse funds, requiring school nurses to focus solely on health services (like health education and emergency response) rather than instructional duties. The bill extends until June 2028 the temporary use of the federal health insurance marketplace for determining Medicaid eligibility, and clarifies that Medicaid coverage for people released from prison continues for up to 12 months post-release. It also updates Medicaid provider screening rules to align with federal standards, particularly for Indian Health Program providers.