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Old North State Report
March 28, 2025
Old North State Report – March 28, 2025
UPCOMING EVENTS
March 31, 2025
IIANC Thinkers Lunch: What Do Voters Want?
April 1, 2025
Wake County Bar Association April Luncheon – Raleigh
April 8, 2025
NC Chamber Spring Member Roundtable - Raleigh
April 14, 2025
Raleigh Chamber Business After Hours - Raleigh
NOTE: We could sponsor a future Business After Hours at the firm for $1,500
April 16, 2025
Federalist Society Housing Policy and Regulation in NC – Raleigh
April 17, 2025
NC Chamber Building NC - Durham
April 22, 2025
NC Chamber Spring Member Roundtable – Asheville
April 23, 2025
RTAC – Association of Corporate Counsel Spring Reception – (Raleigh)
April 24, 2025
Raleigh Chamber Young Professionals Network Social - Raleigh
LEGISLATIVE NEWS
MEDICAL TRANSPARENCY BILL ADVANCES TO HOUSE
Senate Bill 316, which aims to restrict surprise billing by hospitals, passed the North Carolina Senate with a vote of 44-2 on Thursday, pushing for greater patient transparency. The bill seeks to help patients know the costs of medical procedures beforehand, increase certainty about in-network or out-of-network care, and prevent delayed billing.
It also includes new requirements for insurance companies, like a three-day timeline for prior authorizations, and mandates hospitals to provide itemized bills before collections can occur.
The bill moves to the state House, which has previously opposed similar measures due to hospital industry lobbying. Supporters believe it could improve healthcare decisions and reduce costs, while some Democrats are worried about its impact on hospital budgets.
MEDICAID WORK REQUIREMENT LEGISLATION INTRODUCED
Two identical bills, House Bill 491 and Senate Bill 403, were introduced this week to update work requirements related to the 2023 Medicaid expansion law in North Carolina. Representative Donny Lambeth (R-Forsyth), a main sponsor of the House bill, stated it aims to show that North Carolina supports work requirements and to help prevent federal budget cuts that could impact Medicaid expansion in the state.
The 2023 law includes a provision that would end Medicaid expansion if federal funding is reduced. Currently, the federal government covers 90% of the costs for those covered under Medicaid expansion. Recent proposals for budget cuts included work requirements and funding reductions. Since December 2023, around 640,000 North Carolinians have enrolled in expanded Medicaid, primarily adults under 65 earning below 138% of the federal poverty level. According to Lambeth, approximately 80% of individuals who obtained insurance coverage through expansion are already employed. The new bills require the state to implement approved work requirements if federal permission is granted.
BILL TO REPEAL CON LAWS INTRODUCED IN BOTH CHAMBERS
State lawmakers recently filed legislation to repeal North Carolina’s Certificate of Need (CON) laws, which limit the creation or growth of healthcare facilities and services in the state. These laws require healthcare providers to obtain a "certificate of need" for new facilities, added hospital beds, or major medical equipment, making the process time-consuming and costly.
Senate Bill 370 and its companion, House Bill 455, seek to fully repeal these laws, removing the need for state approval for certain healthcare expansions by January 1, 2026. The bill also repeals related statutes and updates various general statutes, redefining terms and adjusting licensing rules accordingly. The new definition of “healthcare facility” creates a complete list of facility types without relying on previous CON references.
NURSING BILL INTRODUCED IN HOUSE
A bill to give advanced practice registered nurses (APRNs) more authority to treat patients was introduced in the House on Tuesday by Representatives Donna McDowell White (R-Johnston), Donny Lambeth (R-Forsyth), Mitchell Setzer (R-Catawba), and Carla Cunningham (D-Mecklenburg). Currently, APRNs require a supervising doctor for some services in North Carolina. House Bill 514 would allow APRNs, including certified registered nurse anesthetists, to perform all their licensed duties without doctor supervision.
Supporters argue the bill could save North Carolinians over $650 million each year on healthcare costs and improve access to quality care, especially in rural areas. The North Carolina Nurses Association and bipartisan lawmakers, including Senator Gale Adcock, support the bill. However, doctor groups oppose it, citing concerns over patient safety. The bill is now with the House Committee on Health for review.
WORKERS’ COMPENSATION UPDATE PROPOSED
Senate Bill 703, introduced in the North Carolina General Assembly on Tuesday, aims to change the Workers' Compensation Act by increasing certain benefits and allowing automatic adjustments based on the Consumer Price Index (CPI). Starting July 1, 2026, the bill raises the minimum weekly compensation for total incapacity from $30 to $50, with yearly CPI adjustments. It also increases the maximum compensation amounts for serious facial disfigurement from $20,000 to $56,000, for serious bodily disfigurement from $10,000 to $28,000, and for the loss or injury to important organs from $20,000 to $56,000. The bill, introduced by Senator Danny Britt (R-Robeson) and Buck Newton (R-Wilson), seeks to ensure compensation aligns with inflation for fair payment to injured workers. It is currently in the Senate Rules Committee.
THE DAVE ACT
Senate Republicans in North Carolina have introduced the DAVE Act, inspired by the Department of Government Efficiency in Washington D. C. Senate Leader Phil Berger filed Senate Bill 474, which establishes a Division of Accountability, Value, and Efficiency (DAVE) in the State Auditor’s office. This initiative aims to improve government efficiency at the state level. A Committee on Government Efficiency was also formed to look for waste in state and local operations.
State Auditor Dave Boliek is tasked with ensuring proper use of resources and is expected to report by the year's end on which state agencies and positions can be cut. Governor Josh Stein has expressed support for making government more cost-effective by launching an “impact center.” The bill requires approval from both the House and Senate to become law.
WHAT WE’RE LISTENING TO
- Under the Dome Podcast
- Do Politics Better Podcast
- WUNC Politics Podcast
- Carolina Newsmakers Podcast
- NC Capitol Wrap Podcast
WHAT WE’RE READING
GET IN TOUCH
These materials have been prepared for informational purposes only and are not legal advice. This information is not intended to create, and receipt of it does not constitute, an attorney-client relationship. Internet subscribers and online readers should not act upon this information without seeking professional counsel.