HB 727 North Carolina House · 2025-2026 Session

Limit Medicaid Reimb. for Facility Fees.

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.

Issues: ✓ Healthcare

Bill status passed both 4 of 5 stages cleared

Introduction

Apr 2025

Committee Review

May 2026

House Passage

May 2025

Senate Passage

May 2026

Governor

Introduced Apr 2, 2025 Last action May 12, 2026

Maddy AI version diff · 3 comparisons

What changed between versions

Edition 2 → Edition 3 · 4 edits

MODERATE

The bill was completely rewritten to shift focus from regulating marriage and family therapy licenses to limiting Medicaid reimbursement for facility fees. The original text regarding therapist licensure reciprocity and criminal history checks was removed, while new provisions were added to restrict Medicaid payments for facility fees unless services are provided on a hospital's main campus or at specific ambulatory surgical facilities.

Scope change

The bill's scope changed entirely from professional licensure regulation to Medicaid payment policy regarding hospital facility fees.

SCOPE

Removed all provisions related to marriage and family therapy licensure, including requirements for reciprocal licensing and criminal history checks for applicants.

REQUIREMENT

Added a mandate for the Department of Health and Human Services to stop reimbursing Medicaid for facility fees unless services are provided on a hospital's main campus, at a facility with an emergency department, or at an ambulatory surgical facility.

DEFINITION

Introduced new definitions for 'Ambulatory surgical facility', 'Campus', 'Facility fee', 'Hospital', and 'Professional fee' to clarify which services and locations are covered.

TIMELINE

Changed the effective date from October 1, 2025, to 'when it becomes law', and added a sunset clause stating the requirements end on June 30, 2027.

Floor votes · Senate May 6, 2026 · House May 7, 2025

How they voted

42–2

Passed · 6 other

Total votes 50

May 6, 2026

D Democratic19

13 Yea 2 Nay 4

68% Yea

R Republican31

29 Yea 2

93% Yea

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

May 12, 2026

Committee

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

lower

May 6, 2026

Upper · Passed

Passed 3rd Reading

upper

May 5, 2026

Upper · Passed

Reptd Fav

upper

Apr 30, 2026

Committee

Re-ref Com On Rules and Operations of the Senate

upper

Apr 30, 2026

Upper · Passed

Com Substitute Adopted

upper

Apr 30, 2026

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 7, 2025

Committee

Ref To Com On Rules and Operations of the Senate

upper

May 7, 2025

Lower · Passed

Passed 3rd Reading

lower

May 6, 2025

Committee

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

lower

May 6, 2025

Lower · Passed

Reptd Fav

lower

Apr 29, 2025

Committee

Re-ref Com On Regulatory Reform

lower

Apr 29, 2025

Lower · Passed

Reptd Fav Com Substitute

lower

Apr 3, 2025

Committee

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

lower

Apr 2, 2025

Introduced

Filed

lower

3 primary · 2 co-sponsors