May 18, 2026

House Health addressed a growing issue in North Carolina this week with a report on emergency department boarding. Carolina Complete Health Network was front and center during the committee meeting, presenting findings from its pilot program aimed at reducing behavioral health boarding for children in emergency departments. The program focused on a three-pronged approach: dedicated behavioral health clinicians in the ED, community-based mobile outreach response, and public education on available crisis services. A key component of the program was its payer-blind nature, serving all eligible children regardless of insurance status. The outcomes demonstrated significant success. The average hold time for children with behavioral health needs in the ED decreased from four to six weeks to 2.1 days, while the “left without being seen” rate decreased by 45%. CCHN plans to enter phase two by expanding into less resource-dense areas and exploring statewide implementation.

May 11, 2026

As reported earlier this week, Speaker of the House Dustin Hall and Senate President Pro Tempore Phil Berger held a joint press conference outlining the key framework established to begin final work on North Carolina’s budget. Many of the major issues that had previously stalled negotiations appear to have been addressed. Lawmakers now have a clearer understanding of proposed state employee raises and anticipated tax rate changes moving forward. With many of the most difficult negotiations reportedly resolved, conference discussions on the budget are expected to move quickly.

The House Health Committee met Tuesday, May 12, with a substantial agenda focused heavily on healthcare and child services. First on the agenda was HB 1166 – Reorganize & Fund Rare Disease Advisory Council. This legislation seeks to reorganize appointments to the Rare Disease Advisory Council and transfer the council under the Department of Health and Human Services (DHHS). The bill builds upon legislation originally enacted in 2015 and continues North Carolina’s longstanding leadership in rare disease advocacy, as the state was the first in the nation to establish such a council within state government. Another major topic of discussion was HB 1086 – Child Care and Early Childhood Development. The bill has drawn significant stakeholder involvement, including participation from the YMCA, the North Carolina Chamber, and Smart Start. The legislation proposes the creation of a career-ready lead teacher program, expansion of childcare academies, and funding for mental and behavioral health services for children and families within childcare facilities. The committee also considered HB 1090 – Rural Healthcare Infrastructure Fund, which appeared to receive strong bipartisan support. North Carolina currently has the second-largest rural population in the country. Over the last decade, nine rural hospitals have closed their OB services, while twelve rural hospitals have closed entirely since 2006. The bill seeks to establish a dedicated infrastructure improvement fund recognizing the state’s responsibility to maintain healthcare access for rural communities. The proposed fund would be eligible to receive state, federal, and economic development dollars. Additionally, the legislation creates a Rural Healthcare Council with appointments made by both the General Assembly and the Governor.

The Senate Health Care Committee also drew significant statewide attention this week following the introduction of Senator Burgin’s SB 863 – Duplicated Inspections in Adult Care Homes. Reports from facilities across the state have highlighted concerns regarding excessive duplicate inspections at adult care homes. The bill aims to reduce redundancy while maintaining patient safety standards. During committee discussion, lawmakers clarified that many of the inspections in question were not directly related to healthcare services, but instead focused on overlapping regulatory areas such as pest control inspections. Under the proposal, if one qualifying inspection has already occurred, other state departments or local entities would be required to recognize that inspection rather than conducting an additional review. The legislation is currently being worked on alongside DHHS due to concerns surrounding specific language and ensuring the bill appropriately balances reducing burdens on facilities while maintaining patient health and safety protections. The discussion in Senate Health did not stop there. Another major point of debate was SB 1040 – Repeal CON for ASCs and Inpatient Rehab. The bill proposes targeted repeal language for Certificate of Need (CON) requirements involving ambulatory surgical centers, inpatient rehabilitation facilities, and related inventory provisions. During committee discussion, several Senators described the bill as only a small piece of a much larger healthcare policy conversation, with some lawmakers expressing broader interest in fully repealing CON laws in North Carolina. The hearing generated extensive discussion surrounding open-market healthcare models and the future direction of healthcare access and competition within the state.

May 4, 2026

In the Senate, lawmakers approved the second and third readings of HB 390 – Medicaid Prepaid Health Plan Practices. The bill prohibits DHHS from preventing managed care plans from developing a standardized coding system for provider claims and allows PHPs to direct outpatient laboratory services to more cost-effective sites. An amendment was introduced to revise wording in one of the bill’s provisions, incorporating language from DHHS. The bill passed both readings and was sent back to the House, where it will be added to the calendar. The Senate also approved HB 727 – Limit Medicaid Reimbursement for Facility Fees. This bill seeks to limit Medicaid reimbursement for facility fees to services provided in specific hospital-based locations, including the main hospital building, areas adjacent to the main building, and other structures located within 250 yards of the main building. The bill was sent back to the House for concurrence with the Senate committee substitute.

Behind the scenes, budget discussions continued. Speaker Destin Hall reported “meaningful” progress on the state budget, though no final deal has been reached. Reported priorities include proposed 8% raises for teachers, state employees, and law enforcement. Senate President Pro Tempore Phil Berger also released a statement Wednesday expressing his eagerness to begin the budget process rather than waiting for a full agreement before negotiations move forward.

In more local healthcare news, WakeMed and Atrium Health announced a planned strategic combination this week aimed at expanding healthcare access across North Carolina. The announcement, made May 6, includes at least $2 billion in planned investments to support the development of new hospitals, healthcare facilities, and expanded patient services throughout the state. One of the primary goals of the combination is to increase healthcare access for communities across North Carolina through expanded in-person and virtual care services. The partnership plans to establish North Carolina’s largest virtual care network, with expectations of adding more than 100,000 new virtual visits annually. Another major component of the proposal is the creation of the state’s largest nonprofit behavioral health network, which would add approximately 360 new inpatient behavioral health beds. Leaders from both healthcare systems stated that the combination is intended to strengthen patient access, improve care delivery, and address growing healthcare demands across the region. We will continue monitoring developments surrounding this partnership and the potential impact it may have on healthcare access and delivery throughout North Carolina.

April 27, 2026

As session begins to gain momentum, overall floor activity remained relatively limited, with both the House and Senate holding light voting sessions alongside a handful of committee meetings. The primary focus this week centered on bill filings, with the General Assembly surpassing 150 filed bills. These proposals span a broad range of issues, including social media and artificial intelligence regulation, affordable housing initiatives, and funding for rural town hall renovations.

The Senate Appropriations Committee met to discuss SB 800 – Zero-Based Budgeting, focusing on identifying inefficiencies and potential cost savings through a restructuring of the budgeting process.

The first law of the session was enacted Thursday, as Josh Stein signed HB 696—Medicaid & HHS Adjustments and Other Critical Needs—into law. The legislation provides full funding for Medicaid, addressing immediate budgetary pressures within the program. While the bill does not resolve all underlying challenges, Governor Stein emphasized his commitment to working collaboratively with the General Assembly to ensure a productive short session and to pursue additional solutions moving forward.

As the short session progresses, legislative activity is expected to accelerate, with increased floor votes and committee engagement in the coming weeks.

April 23, 2026