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Yes: 579 • No: 7
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, 5 costs, 10 mixed.
Conditional funding for Guilford airplane project
If the Economic Investment Committee awards a qualifying grant for an airplane factory in Guilford County, the state provides $118.1 million one-time in 2025–2026. The money is split for land ($15.0 million), site work ($45.0 million), roads ($7.9 million), water/sewer ($5.0 million), renovations and FAA needs ($10.2 million), and building manufacturing and R&D space ($35.0 million). Recipients face limits on selling or encumbering land or improvements, and surpluses may be shifted among these uses. Annual reports are due each September 1 while funds remain unspent.
Reworked hospital funding and HASP rules
Starting July 1, 2026, public hospital assessment formulas shift to use IGT actual receipts adjustments divided by total costs. The law defines related IGT components and offsets and lets plans require itemized bills for inpatient claims over $250,000 or big outliers. The Medicaid agency must choose the HASP method that maximizes federally approved hospital reimbursements. If CMS approvals or payments fall under set thresholds (for example, under $1.5 billion in gross HASP reimbursements) or IGTs drop 20% in a quarter, the agency must report within 120 days after a 30‑day stakeholder review.
DME and prosthetics pay held steady
From July 1, 2025 through June 30, 2027, managed‑care payments for durable medical equipment, orthotics, and prosthetics stay at 100% of the lower of the supplier’s usual charge or the Medicaid fee‑for‑service limit. This helps keep supplier participation and patient access.
Stronger Medicaid provider networks
Medicaid plans must keep open networks and include essential providers like community health centers, rural health centers, free clinics, local health departments, and State Veterans Homes. Behavioral health and IDD plans must include essential providers and accept qualified providers who take network rates. The Children and Families specialty plan must build networks for intensive in‑home and residential treatments and cannot exclude tribal or Indian Health Service providers.
$319M for Medicaid and yearly audit
The state provides $319 million one time for FY 2025–2026 (effective July 1, 2025) to cover Medicaid enrollment, services, capitation, federal match changes, and the Children and Families specialty plan. Each year by October 1, the state reports improper Medicaid payments and recoveries to lawmakers.
Medicaid copays set to federal max
Beginning July 1, 2027, the state sets Medicaid copays each year at the highest amounts federal law allows. This likely raises what you pay when you use covered services.
Stricter SNAP proof and income counting
The state stops using only self‑attestation for SNAP unless federal law requires it. The agency must count all income and resources of anyone found ineligible under 7 U.S.C. § 2015(f) and cannot prorate or exclude that person’s income. Households with such members may see lower benefits or lose eligibility.
Tighter Medicaid proof and checks
Starting October 1, 2026, the state stops accepting only your self-attestation to prove Medicaid eligibility unless federal law requires it. The state counts income from household members who are ineligible due to immigration status unless federal rules say not to. The state checks your income and job status at least monthly. If citizenship or immigration status cannot be verified after a fair chance, or shows certain unlawful presence, the state refers the case to federal immigration authorities.
Work rules for Medicaid adults
Starting January 1, 2027, you must show proof of community engagement when federal law allows Medicaid work rules. New applicants must show three straight months before applying. At renewal, you must show at least three of the last six months. Lack of proof can delay or stop coverage.
Limits and staffing for overnight respite
Starting July 1, 2026, one adult can use no more than 14 straight days and 60 total days of overnight respite in any 365 days, unless a waiver allows more. Facilities must keep awake staff on duty based on census, and facilities are capped at 12 beds. Staff on that shift cannot also do housekeeping or food service. The Medical Care Commission can use emergency rules to put these changes in place.
Medicaid rules for some noncitizens
Beginning October 1, 2026, certain noncitizens can get Medicaid through an Alternative Benefit Plan if they meet or are exempt from federally approved work or community engagement rules. Coverage for noncitizens stays limited to what federal law requires. Also starting October 1, 2026, managed care plans do not include people who are only eligible for emergency services due to immigration status; those people get emergency care only.
New rules for autism therapy
Paraprofessional autism services must mostly be in person, and Licensed Qualified providers must assess patients in person unless an exception applies. At least 10% of paraprofessional hours must include direct observation by the supervisor, and plans over 16 hours a week need extra approval and parent training. Paraprofessionals must get RBT or ABAT certification after a 120-day grace period. Out-of-state BCBA and similar supervisors cannot enroll in NC Medicaid. The state can recoup payments for violations and can suspend a provider for 1–2 years after a third serious violation.
More scholarships for veterans' children
The law boosts aid for children of wartime veterans. For 2025–2026, it adds $1 million to raise awards up to the full allowed amounts. Beginning 2026–2027, it provides $10 million each year to fund more scholarships. Starting with new applications for 2026–2027, Class II and Class III slots can rise from 100 to 200 each. For 2024–2025 through 2026–2027, the Authority can prioritize applicants, reduce room and board allowances, set standard payments, run lotteries, or give pro rata awards when funds are tight.
Tougher prepayment review for providers
Providers stay under prepayment review until they post three straight months with at least an 80% clean claims rate and submit at least half their prior monthly average claims. Reviews cannot run longer than 24 months unless an appeal of a termination or sanction is pending. Plans can place providers under review and seek to exclude them with state approval, which is deemed approved if the state does not answer in 90 days.
Medicaid plan due; some changes sunset
The Medicaid agency must deliver a plan to improve outcomes, integrity, and savings by October 1, 2026. The plan can include new ways to manage GLP‑1 weight‑loss drugs, including required nutrition and lifestyle programs. The plan cannot start before July 1, 2027. Unless the law says otherwise, temporary Medicaid changes in this Part can end after June 30, 2027.
2026 hospital fee and admin funding
A one‑time 2026 hospital assessment is collected; the total equals $14.3 million minus intergovernmental transfer receipts. $7.8 million of the proceeds goes to county social services, and the rest supports specified administrative costs. Hospitals must pay within 7 days; the state can withhold unpaid amounts and penalties cannot be passed to patients. Counties get $7.8 million per quarter in FY 2026–2027 for administration, and State quarterly amounts are set at $0 (Jul 1, 2026), $3.3 million (Oct 1, 2026), $2.35 million (Jan 1, 2027), and $3.3 million (Apr 1, 2027). From FY 2027–2028 through FY 2035–2036, quarterly supplemental amounts rise with CPI‑U; they are $0 starting July 1, 2036.
Audit of Medicaid and NCWorks funded
The State Auditor must perform a performance audit of Medicaid administration and NCWorks Career Centers. The law provides a one‑time $500,000 in FY 2026–2027 to fund this audit.
Funds to keep DMV and safety running
The state shores up key operations. DMV gets $13.1 million each year starting 2025–2026 and $8.5 million one-time in 2025–2026 to cover a shortfall from credit card fee receipts. The State Bureau of Investigation gets $2.5 million each year starting 2025–2026 and $1.2 million one-time in 2025–2026 to cover an operating shortfall. The courts get $165,000 one-time in 2025–2026 to extend Business Court case management software. The General Assembly gets $1.5 million one-time in 2025–2026 for operating costs.
Hertford can redirect water funds
The Town of Hertford may use its earlier water funding for any water or wastewater project. The law removes the prior limit that tied the money to a single water capacity increase.
One‑time $80M for Adult Correction
The state provides a one‑time $80 million in FY 2025–2026 to the Department of Adult Correction to cover an operating shortfall.
Study on centralizing social services
By October 31, 2026, the budget office must seek a contractor to study moving social services administration to the state. The study must review costs, workforce, timelines, risks, and data sharing with input from counties and DHHS. The law provides a one‑time $1,000,000 in FY 2026–2027 to fund the study.
New education commission on schools
The law creates a 29-member Blue Ribbon Commission on Public Education. It has 19 voting members and 10 nonvoting legislators, with co-chairs named jointly. The Friday Institute and the legislature provide staff. The law gives $300,000 in 2025–2026 to run the commission, and the funds stay available until June 30, 2027. The commission ends March 1, 2027.
More time to use state grants
Directed grant funds for 2023–2024 and 2024–2025 do not revert until June 30, 2027. Also, funds unspent as of December 31, 2024 now revert at the end of the 2026–2027 fiscal year, instead of 2025–2026. This gives agencies and grantees more time to use the money.
Required transfers from mental health plans
Local management entities/managed care organizations must transfer a total of $18,028,217 in 2025–2026 and the same in 2026–2027. The state sets due dates and can reallocate amounts if counties realign. This requirement is effective July 1, 2025.
Updates tax rules for 529 plans
The law updates the federal tax code date used for the state's Parental Savings Trust Fund (529 plans) to July 4, 2025. This sets which federal rules apply to North Carolina 529 accounts.
Shifts in local directed grants
The law shifts several earlier directed grants to new local recipients or uses. Examples: $2 million is split between Avery and Mitchell Counties; $800,000 moves from the Town of Selma to the Johnston County Economic Development Corporation; $5 million in Iredell County is divided between the sheriff ($3 million) and the City of Statesville ($2 million); park and water projects are updated in Harnett and Burke Counties. These changes only affect the named local projects.
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
House vote • 4/28/2026
HB 696: Medicaid & HHS Adjust./Other Critical Needs.
Yes: 113 • No: 2 • Other: 5
Senate vote • 4/28/2026
HB 696: Medicaid & HHS Adjust./Other Critical Needs.
Yes: 45 • No: 3 • Other: 2
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
Edition 1
Edition 2
Edition 3
Edition 4
Filed
Latest Edition
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