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North CarolinaHB 6962025-2026 SessionHouseWALLET
AN ACT TO PROMOTE HEALTH CARE PRACTITIONER TRANSPARENCY THROUGH ADVERTISEMENT REQUIREMENTS.
Sponsored By: MD Grant L. Campbell (Republican), Larry W. Potts (Republican), MD Timothy Reeder (Republican)
Signed by Governor
ADMINISTRATIVE CODEADMINISTRATIVE RULESADVERTISING & MARKETINGALTERNATIVE MEDICINECHIROPRACTORSCOMMUNICATIONSCOUNSELINGDENTISTS & DENTISTRYEMPLOYMENTFOODS & BEVERAGESHEALTH SERVICESMENTAL HEALTHNURSES & NURSINGNUTRITIONOCCUPATIONAL THERAPYOCCUPATIONSOPTICIANS & OPTOMETRISTSPERSONNELPHARMACEUTICALSPHARMACISTS & PHARMACIESPHYSICAL THERAPYPHYSICIANSPRESENTEDPSYCHIATRYPSYCHOLOGYPUBLICPUBLIC HEALTHRATIFIEDSPEECH PATHOLOGISTS & AUDIOLOGISTSCHAPTEREDOPTHALMOLOGY & OPTHALMOLOGISTS
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Bill Overview
Analyzed Economic Effects
26 provisions identified: 11 benefits, 6 costs, 9 mixed.
One-time $319M boost for Medicaid
The law gives $319 million one time for the 2025–2026 year to the state Medicaid agency. The money adjusts for enrollment and cost changes, handles federal match shifts, and supports launching the Children and Families Specialty Plan in December 2025. This funding is retroactive to July 1, 2025.
Proof of community engagement for Medicaid
Starting Jan. 1, 2027, if you are subject to community engagement rules, you must show proof. At application, you must prove three straight months of compliance just before you apply. At renewal, you must show compliance in at least three of the last six months. The law also routes such coverage through an Alternative Benefit Plan, unless you are exempt under federal rules.
Stricter Medicaid checks and copays
The law checks for changes in your income, job, and residency at least monthly, not quarterly. This makes coverage changes happen faster for Medicaid. Starting July 1, 2027, all Medicaid copays are set at the federal maximum each year. That raises out-of-pocket costs for people on Medicaid.
Tighter Medicaid rules for noncitizens
Starting Oct. 1, 2026, the state limits Medicaid for noncitizens to what federal law requires. Some people subject to the five‑year bar and undocumented immigrants get emergency care only, not full plan coverage. The state counts the income of household members who are ineligible due to immigration status when it decides your eligibility. You cannot rely only on self‑attestation to verify eligibility unless federal law requires it. If the state cannot verify citizenship or status after a reasonable period, it must refer the case to federal Homeland Security.
Many Medicaid changes end June 2027
Unless the law says otherwise, Medicaid changes in this Part end on June 30, 2027. After that, the Department does not have to keep these modifications. This may reduce benefits or access for recipients after that date.
Big state backing for airplane project
If the project is approved, the state provides $118.1 million one time for airport and site work in Guilford County. Funds cover land ($15M), site work ($45M), roads ($7.9M), water and sewer ($5M), renovations and FAA offsets ($10.2M), and a manufacturing/R&D building ($35M). The company must invest at least $4.5 billion and create at least 14,000 jobs with average pay of $89,340. Land bought or improved with these funds cannot be sold or encumbered for a set term, and leases need approval. Limited collateral rules apply to protect the funded property.
Medicaid plans must keep key providers
Prepaid Medicaid plans must keep open networks that meet access rules and include essential providers. Essential groups include community health centers, rural health centers, free clinics, local health departments, and State Veterans Homes. Tailored behavioral plans must follow the same network rules and include essential providers in closed networks. The Children and Families specialty plan runs a closed network for certain services but cannot exclude tribal or Indian Health Service providers.
Guaranteed payments for DME and prosthetics
The law guarantees payment for durable medical equipment, orthotics, and prosthetics during the first seven years of initial capitated contracts. Payments are 100% of the lower of the supplier’s usual rate or the Medicaid fee‑for‑service rate. The extension is retroactive to July 1, 2025 and ends June 30, 2027.
Extra funds for Corrections and SBI
The Department of Adult Correction gets $80 million one time for 2025–2026 to cover an operating shortfall. The State Bureau of Investigation gets $2.5 million each year starting in 2025–2026 and $1.2 million one time in 2025–2026. These funds help keep core public safety operations running.
More oversight of rural health funds
The health department must report on the Rural Health Transformation Plan from Aug. 1, 2026 through July 31, 2031. Reports include updates to federal officials, total funds by initiative, and county‑level subrecipient details. The law also adds clear definitions for program terms and partners to make oversight easier.
Education commission to review schools
The law creates a 29‑member Blue Ribbon Commission on Public Education to study how schools are structured and run. The Friday Institute and Legislative Services support the work. The Commission ends March 1, 2027. The law provides $300,000 one time in 2025-2026 to run the Commission, and the money stays available until June 30, 2027.
Stricter SNAP proof and income counting
SNAP (Food and Nutrition Services) cannot rely only on self‑attestation unless federal law requires it. If a household has a person ineligible under 7 U.S.C. §2015(f), all of that person’s income and resources count in the household’s calculation. The agency cannot prorate or exclude that income. These rules can lower benefits or end eligibility for some households.
Stricter claims review for Medicaid providers
Providers must reach an 80% clean‑claims rate for three straight months to leave prepayment review. Reviews cannot last more than 24 months unless appeals are pending. Plans can ask to drop providers who fail the 80% test; a request is deemed approved if the state does not answer in 90 days. Plans can also require itemized bills for very large inpatient claims over $250,000 or more than two standard deviations above the median, except where federal rules say otherwise.
Autism therapy: telehealth and supervision limits
Autism treatment rules now cap licensed provider telehealth to 50% unless an exception applies. At least 10% of paraprofessional services must be observed and directed by a licensed provider. New paraprofessionals have 120 days to get required certification. In‑person assessments are required, with limited exceptions. Out‑of‑state behavior analysts cannot enroll under the specified subsections, and the state can recoup payments for noncompliance.
More scholarships, new rules for veterans' kids
The law adds $1 million one time in 2025-2026 to raise scholarship awards for children of wartime veterans to the full amounts allowed. Any money left can fund more scholarships starting in 2026-2027. Beginning in 2026-2027, $10 million a year from the Escheat Fund supports more of these scholarships. For 2024-2025 through 2026-2027, the state may set priorities, cut room and board or private college allowances for 2025-2026 (by August 15, 2025), standardize payments for 2026-2027, or use a lottery or pro rata awards if money is short. For 2026-2027, new Class II and Class III scholarships can grow from 100 to 200 in each class.
Plan to improve Medicaid by 2027
The Medicaid division must deliver a plan by Oct. 1, 2026 to improve outcomes, program integrity, and efficiency. The plan must cover admin cost cuts, more flexibility for plans and providers, rate alignment, and ways to manage high‑cost GLP‑1 drugs. Implementation cannot start before July 1, 2027 and must include stakeholder input.
Hospital payment formulas and HASP rules
Starting July 1, 2026, the state changes how public hospital assessments and intergovernmental transfer offsets are calculated, with some parts applying Oct. 1, 2026. The Medicaid agency must pick the HASP method that maximizes allowable hospital payments if federally approved. If HASP payments fall below set thresholds (under 95% of the federal max, or under $1.5 billion a year, or transfers drop 20%), the agency must report to lawmakers within 120 days. The law repeals a prior section and sets timing rules for future assessment provisions. If admin costs later drop, the agency must propose cutting related hospital assessments, and by Oct. 1, 2031 it must report funding options after June 30, 2036.
New safety rules for overnight respite
Adult day programs that offer overnight respite must follow new limits and staffing rules. Stays are capped at 14 straight days and 60 days a year, or the limit in certain waivers. Minimum awake staff are required based on census, with at least one staff qualified to give medicine for up to six people and two staff for seven to twelve. Staff on care shifts cannot do housekeeping or food service. The Commission can use emergency rules so these protections start right away.
Audits and reports to tighten Medicaid
The State Auditor will run a performance audit of Medicaid and NCWorks. The law provides $500,000 one time in 2026–2027 to pay for the audit. Starting Oct. 1, 2029, the health department must send a yearly report on improper Medicaid payments and recoveries to lawmakers.
Local grants get more time and redirects
Nonrecurring directed grants for 2023-2024 and 2024-2025 do not revert until June 30, 2027. Funds in S.L. 2025‑4 that were unspent as of December 31, 2024 revert at the end of 2026‑2027. Several grants are redirected, including $2 million split to Avery and Mitchell Counties, $800,000 to the Johnston County EDC, $3 million to the Iredell County Sheriff’s Office, $2 million to the City of Statesville, and $1.6 million for Harnett park work. The Town of Hertford can use prior water funds for any water or wastewater project. If this act conflicts with G.S. 143C‑5‑4, this act controls, and budget allotments adjust from July 1 when the main appropriations act becomes law.
One-time funds for courts and legislature
The law gives $165,000 one time in 2025-2026 to extend Business Court case management software. It also provides $1.5 million one time in 2025-2026 for General Assembly operating costs.
DMV funding and tighter estimates
The Highway Fund provides $13.1 million each year starting in 2025-2026 and $8.5 million one time in 2025-2026 to the DMV. This covers a shortfall from lower‑than‑expected credit card fee receipts. The budget office must match credit card receipt line items to actual collections, and DMV must adjust its projections and base budget.
529 plan rules tied to 2025
The law fixes the federal tax code date used by the state’s 529 college savings law to July 4, 2025. It follows federal provisions enacted by that date, even if they take effect earlier or later. This can change which federal 529 rules the state applies.
Study to centralize social services statewide
By Oct. 31, 2026, the budget office must hire a contractor to study moving all social services administration to the state level. The study will review costs, timelines, workforce needs, risks, and data‑sharing. Lawmakers must get a report with findings and recommendations by June 30, 2027. The state provides a one‑time $1,000,000 on July 1, 2026 to pay for the study.
2026 one-time hospital assessment; county funds
There is a one‑time 2026 assessment on each acute care hospital to raise $14.3 million minus intergovernmental transfer receipts. Money goes to the Health Advancement Receipts Special Fund, and $7.8 million supports county social services for Medicaid redeterminations. Hospitals cannot bill patients for the assessment. The state can set payment rules, impose late penalties, and withhold unpaid amounts. A report to lawmakers is due by Feb. 1, 2027.
Local behavioral plans transfer $18M yearly
Local behavioral health plans must transfer $18,028,217 each year to the state Medicaid division in fiscal years 2025–2026 and 2026–2027. The state sets payment dates and can shift amounts among plans if counties realign, as long as the total stays the same. This requirement is effective July 1, 2025.
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Sponsors & Cosponsors
Sponsors
MD Grant L. Campbell
Republican • House
Larry W. Potts
Republican • House
MD Timothy Reeder
Republican • House
Cosponsors
Cody Huneycutt
Republican • House
Bill Ward
Republican • House
Roll Call Votes
Senate vote • 4/28/2026
HB 696: Medicaid & HHS Adjust./Other Critical Needs.
Yes: 45 • No: 3 • Other: 2
House vote • 4/28/2026
HB 696: Medicaid & HHS Adjust./Other Critical Needs.
Yes: 113 • No: 2 • Other: 5
Senate vote • 4/22/2026
HB 696: Medicaid & HHS Adjust./Other Critical Needs.
Yes: 48 • No: 1 • Other: 1
House vote • 4/22/2026
HB 696: Medicaid & HHS Adjust./Other Critical Needs.
Yes: 112 • No: 1 • Other: 7
House vote • 6/24/2025
HB 696: Health Care Practitioner Transparency Act.
Yes: 111 • No: 0 • Other: 9
Senate vote • 6/19/2025
HB 696: Health Care Practitioner Transparency Act.
Yes: 41 • No: 0 • Other: 9
House vote • 5/6/2025
HB 696: Health Care Practitioner Transparency Act.
Yes: 109 • No: 0 • Other: 9
Actions Timeline
Ch. SL 2026-1
4/30/2026HouseSigned by Gov. 4/30/2026
4/30/2026HousePres. To Gov. 4/28/2026
4/28/2026HouseRatified
4/28/2026HouseOrdered Enrolled
4/28/2026HouseConf Report Adopted 3rd
4/28/2026SenateConf Report Adopted 3rd
4/28/2026HousePlaced On Cal For 04/28/2026
4/22/2026SenateConf Report Passed 2nd
4/22/2026SenatePlaced On Cal For 04/28/2026
4/22/2026HouseConf Report Adopted 2nd
4/22/2026HousePlaced On Cal For 04/22/2026
4/21/2026HouseRuled Material
4/21/2026HouseConf Com Reported
4/21/2026HousePlaced On Cal For 04/22/2026
4/21/2026SenateHeld As Material
4/21/2026SenateConf Com Reported
4/21/2026SenateConferees Changed
4/21/2026HouseConf Com Appointed
6/25/2025SenateConf Com Appointed
6/24/2025HouseFailed Concur In S Com Sub
6/24/2025HouseAdded to Calendar
6/24/2025HouseWithdrawn From Com
6/24/2025HouseRe-ref Com On Rules, Calendar, and Operations of the House
6/23/2025HouseWithdrawn From Cal
6/23/2025House
Bill Text
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Edition 2
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Edition 4
Filed
Latest Edition
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