MEDICAID PREPAID HEALTH PLAN PRACTICES. (NEW)

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View NCGA Bill Details2025-2026 Session
House Bill 390 (Public) Filed Wednesday, March 12, 2025
AN ACT TO ALLOW CERTAIN MEDICAID PREPAID HEALTH PLAN PRACTICES.
Intro. by Cunningham, White, Blackwell, Reeder.
Status: Re-ref Com On Rules, Calendar, and Operations of the House (House action) (May 12 2026)

SOG comments (1):

Long title change

Submitted by iveybyrd on

Senate committee substitute to the 1st edition changes the act's long title. Previous title was AN ACT ESTABLISHING STANDARDS FOR SURGICAL SMOKE EVACUATION IN HOSPITALS AND AMBULATORY SURGICAL FACILITIES.

Bill History:

H 390

Bill Summaries:

  • Bill H 390 (2025-2026)
    Summary date: May 6 2026 - View Summary

    Senate amendment to the 2nd edition makes the following changes. 

    Removes language conditioning the act's changes to GS 108D-65 on House Bill 696, 2025 Regular Session (H 696) becoming law. Makes conforming change to citation of GS 108D-65 in the act. Allows the Department of Health and Human Services to set parameters to ensure consistent claims coding among Prepaid Medicaid Health Plans. Removes provisions amending GS 108D-65 if H 696 did not become law. 

    Government, State Agencies, Department of Health and Human Services, Health and Human Services, Health, Health Care Facilities and Providers, Social Services, Public Assistance
    GS 160D
  • Bill H 390 (2025-2026)
    Summary date: Apr 30 2026 - View Summary

    Senate committee substitute replaces the 1st edition in its entirety with the following.

    Makes conforming changes to act's titles. 

    Specifies that if House Bill 696, 2025 Regular Session (H 696) becomes law, then makes the following changes to GS 108D-65(b) (Role of the Department of Health and Human Services-DHHS), as amended by H 696. Now also prevents DHHS from prohibiting prepaid Medicaid health plans (PHP) from (1) aligning claims operations with national standards for coding, edits, and claims adjudication and (2) directing inpatient hospital and lab services to outpatient settings where appropriate. Authorizes DHHS to establish rules with standards for when referral to outpatient settings is appropriate. Changes the number of standard deviations pertaining to when DHHS cannot prohibit itemized bills to two standard deviations from the mean claim amount (was, two standard deviations from the median claim amount).

    Specifies that if H 696 does not become law by June 1, 2026, then this act makes the same changes as these made to GS 108D-65 in this act and by H 696.

    Effective when it becomes law and applies to contracts entered into or amended after that date. 

    Government, State Agencies, Department of Health and Human Services, Health and Human Services, Health, Health Care Facilities and Providers, Social Services, Public Assistance
    GS 160D
  • Bill H 390 (2025-2026)
    Summary date: Mar 12 2025 - View Summary

    Establishes standards for surgical smoke evacuation in hospitals (new GS 131E-78.4) and ambulatory surgical facilities (new GS 131E-147.2). Requires licensed hospitals and ambulatory surgical facilities to adopt and implement policies that require the use of smoke evacuation/filtering systems during any surgical procedure likely to generate surgical smoke. Defines smoke evacuation/filtering system and surgical smoke. Authorizes the Department of Health and Human Services to take adverse action for violations. Effective January 1, 2026.

    Government, State Agencies, Department of Health and Human Services, Health and Human Services, Health, Health Care Facilities and Providers
    GS 131E
View: All Summaries for Bill