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
Lawmakers returned to Raleigh this week to begin the 2026 legislative short session. Traditionally, the short session focuses on making adjustments to the state budget and advancing key legislation that did not pass during the long session. This year, major priorities include finalizing a budget, addressing Medicaid funding and rebasing, and revisiting several high-profile and previously stalled bills.
The opening week primarily centered on legislative proceedings, including the swearing-in of new members and the introduction and discussion of various House and Senate bills.
In the House, significant attention was given to HB 696 (Medicaid and HHS Adjustments). This legislation addresses several critical areas within Medicaid, including funding, expansion, cost control, and Applied Behavior Analysis (ABA) therapy guidelines. The bill provides approximately $319 million towards the state’s Medicaid rebase for the remainder of the fiscal year and reflects a compromise package developed collaboratively by both the House and Senate. Additionally, the bill includes reforms to ABA therapy, introducing guardrails and clearer standards aimed at ensuring appropriate treatment for children with autism while also seeking potential cost savings for the state.
On the Senate side, a new caucus—the National Security Technology and Innovation Caucus—has been established. The caucus is designed to strengthen collaboration between North Carolina’s research universities, military installations, and private-sector innovators. Its goal is to position the state to better compete nationally in the defense industry and in emerging dual-use and critical technologies, addressing a current gap in North Carolina’s economic portfolio.
As the short session progresses, we expect continued developments and potential shifts in priorities. We will closely monitor legislative activity and provide timely updates as key issues evolve.
