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.