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.
House Bill 618, the "Ivermectin Access Act," directs the State Health Director to issue a statewide standing order that allows licensed pharmacists to dispense ivermectin for human use. Under this order, pharmacists would be authorized to provide ivermectin without requiring a written prescription or consultation from a healthcare professional. The bill also grants immunity from civil or criminal liability to the State Health Director for issuing the order and to any pharmacist who dispenses ivermectin in accordance with it. The State Health Director is required to issue this statewide standing order by October 1, 2025.
HB 567, titled "Ensure Access to Biomarker Testing," mandates that North Carolina health benefit plans provide coverage for biomarker testing for the diagnosis, treatment, and monitoring of various diseases or conditions. This coverage is required when the testing is supported by medical and scientific evidence, such as FDA approval or nationally recognized clinical guidelines. The bill also prohibits insurers from denying coverage, raising premiums, or charging higher rates based on an individual's biomarker information. Additionally, it establishes a 24-hour timeline for insurers to complete utilization reviews for urgent healthcare services, aiming to improve access to diagnostic testing and care for North Carolinians.
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 681 directs the Commission for Mental Health, Developmental Disabilities, and Substance Use Services to update state rules for outpatient opioid treatment programs (OTPs). The bill aims to align these rules more closely with federal regulations governing medications for opioid use disorder, affecting patients receiving treatment and the OTPs providing care. Key changes include removing home environment stability as a criterion for take-home medication and prohibiting administrative discharge due to continued substance use or missed doses. It also reduces the frequency of required drug tests, removes observed testing, and allows OTPs to administer methadone to non-enrolled patients. The Commission must engage with clients and providers for input and publish the proposed amended rules by July 1, 2025.
HB 139, titled "Baby Boxes/Newborn Safety Device," allows for the safe surrender of infants up to 30 days old using a specialized newborn safety device. This bill permits parents to place an infant in these devices, which must have a dual alarm system connected to the facility and be tested monthly. These devices can only be installed at continuously staffed emergency departments, emergency facilities, or social services offices, where qualified healthcare providers, first responders, or social services workers will take temporary custody of the infant. The act is set to become effective on October 1, 2025.
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.