Healthcare

passed · North Carolina · House May 7, 2025

HB 489: Insurance Coverage Emergency Ambulance Transportation.

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.

Topics ✓ HealthcareSupports HealthcareSets minimum ambulance reimbursement rates and caps patient cost-sharing, improving access to emergency services under health insurance.90% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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passed · North Carolina · House May 7, 2025

HB 572: Veterans/Electroencephalogram Combined Transcranial Magnetic Stimulation Pilot Program.

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.

Topics ✓ HealthcareSupports HealthcareAuthorizes pilot program for eTMS mental health treatment access for veterans and first responders, directly expanding healthcare services under mental health and health services subjects.95% confidence ✓ VeteransSupports VeteransEstablishes eTMS pilot program for veterans' mental health/PTSD treatment via Veterans Affairs department, directly expanding healthcare access for covered conditions.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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passed · North Carolina · House May 7, 2025

HB 519: Parents' Medical Bill of Rights.

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.

Topics ✗ HealthcareOpposes HealthcareRestricts minors' access to STD, substance abuse, and mental health care without parental consent, limiting patient autonomy in healthcare services.92% confidence | Rep's Stance ✗ Voted No ✓ Supports Healthcare

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passed · North Carolina · House May 7, 2025

HB 567: Ensure Access to Biomarker Testing.

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.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for evidence-based biomarker testing, prohibits denial/price hikes based on results - expands access and protects patient rights per bill text.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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passed · North Carolina · House May 7, 2025

HB 297: Breast Cancer Prevention Imaging Parity.

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.

Topics ✓ HealthcareSupports HealthcareMandates equal cost-sharing for breast imaging (MRIs, ultrasounds) as mammograms, expanding patient access to necessary diagnostic care without higher out-of-pocket costs.92% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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passed · North Carolina · House May 7, 2025

HB 681: Update Opioid Abatement Treatment Program Rules.

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.

Topics ✓ Criminal JusticeSupports Criminal JusticeRemoves barriers to opioid treatment (home environment stability), aligning with federal standards to improve access and reduce recidivism through rehabilitation, supporting criminal justice reform.85% confidence ✓ HealthcareSupports HealthcareRemoves home stability barrier for take-home meds and prohibits administrative discharge, improving patient access to opioid treatment under federal-aligned rules.90% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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passed · North Carolina · House May 1, 2025

HB 156: Increase Access for Small Employers/Insurance.

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.

Topics ✓ HealthcareSupports HealthcareSets minimum insurance standards (e.g., $20k attachment point) for small employers, directly improving coverage access and protecting against excessive out-of-pocket costs for healthcare services.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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passed · North Carolina · House Apr 30, 2025

HB 163: Pharmacy Benefits Manager Provisions.

HB 163 regulates Pharmacy Benefits Managers (PBMs) to ensure fair practices for pharmacies and insured individuals. The bill prohibits PBMs from charging insurers more for a prescription drug than they pay the pharmacy (spread pricing) and requires patient out-of-pocket costs to be based on the net price after any PBM concessions. It establishes minimum reimbursement standards for pharmacies, preventing PBMs from paying less than the national average drug acquisition cost plus a dispensing fee. Additionally, it clarifies that PBMs cannot restrict accredited pharmacies from dispensing specialty drugs and strengthens audit protections for pharmacies.

Topics ✓ HealthcareSupports HealthcareProhibits spread pricing and mandates fair reimbursement for pharmacies, lowering patient costs and ensuring access to medications within healthcare services.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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passed · North Carolina · House Apr 30, 2025

HB 107: Adopt Sudden Unexpected Death in Epilepsy (SUDEP) Awareness Week.

House Bill 107 designates the second week of November each year as Sudden Unexpected Death in Epilepsy (SUDEP) Awareness Week in North Carolina. Additionally, it encourages local boards of education to develop and offer seizure awareness training for school personnel who are responsible for students with epilepsy or who are otherwise predisposed to seizures. This training aims to provide school staff with information to support these students.

Topics ✓ HealthcareSupports HealthcareDesignates SUDEP Awareness Week and mandates school seizure training, advancing public health education for epilepsy management.90% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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passed · North Carolina · House Apr 30, 2025

HB 152: Access to Transcranial Magnetic Stimulation.

HB 152 aims to regulate how health benefit plans in North Carolina cover Transcranial Magnetic Stimulation (TMS) services. If an insurer chooses to cover TMS, the bill requires them to cover all procedures performed by properly licensed healthcare providers, regardless of their medical specialty, as long as TMS is within their scope of practice. It prohibits insurers from penalizing providers solely based on their specialty when submitting TMS claims. However, the bill maintains that insurers retain discretion over whether to cover TMS, for which conditions, and at what reimbursement rates.

Topics ✓ HealthcareSupports HealthcareMandates insurer coverage of TMS procedures without specialty restrictions, expanding access to mental health services under health insurance regulations.95% confidence | Rep's Stance ✓ Voted Yes ✓ Supports Healthcare

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