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GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 3
HOUSE BILL 192
Committee Substitute Favorable 6/24/25
Senate Appropriations/Base Budget Committee Substitute Adopted 9/22/25
Short Title: Defund Planned Parenthood & Cost Transparency. (Public)
Sponsors:
Referred to:
February 26, 2025
*H192-v-3*
A BILL TO BE ENTITLED 1
AN ACT TO PROVIDE GR EATER FAIRNESS IN BI LLING AND COLLECTION S 2
PRACTICES FOR HOSPIT ALS AND AMBULATORY S URGICAL FACILITIES A ND 3
TO PROHIBIT PLANNED PARENTHOOD PARTICIPATION IN MEDICAID. 4
Whereas, on January 24, 2025, President Donald J. Trump issued Executive Order 5
14182, Enforcing the Hyde Amendment, which reinforced that the policy of the United States is 6
to end the forced use of federal taxpayer dollars to fund or promote elective abortion. President 7
Trump also reversed prior actions f rom the Biden administration that disregarded and 8
contradicted the Hyde amendment; and 9
Whereas, Congress passed and President Trump signed H.R. 1, the One Big Beautiful 10
Bill Act, which included the federal defunding of elective abortion centers like Planne d 11
Parenthood for the next year; and 12
Whereas, in its June 26, 2025, ruling in Medina v. Planned Parenthood , the U.S. 13
Supreme Court affirmed the right of states to bar Planned Parenthood from receiving Medicaid 14
funds; and 15
Whereas, Americans and North Carolin ians have made clear that they do not want 16
their tax dollars subsidizing abortions; Now, therefore, 17
The General Assembly of North Carolina enacts: 18
19
PROHIBIT PLANNED PARENTHOOD PARTICIPATION IN MEDICAID 20
SECTION 1.(a) The Department of Health and Human Services, Division of Health 21
Benefits, shall do all of the following: 22
(1) Disenroll Planned Parenthood Federation of America, Inc., and associated 23
entities as Medicaid providers. 24
(2) Discontinue any Medicaid contracts with Planned Parenthood Federation of 25
America, Inc., and associated entities. 26
(3) Engage other Medicaid providers to provide Medicaid services previously 27
provided by Planned Parenthood Federation of America, Inc., and associated 28
entities. 29
SECTION 1.(b) This section is effective when it becomes law. 30
31
GREATER FAIRNESS IN BILLING AND COLLECTI ONS PRACTICES FOR 32
HOSPITALS AND AMBULATORY SURGICAL FACILITIES 33
General Assembly Of North Carolina Session 2025
Page 2 House Bill 192-Third Edition
SECTION 2.(a) Chapter 131E of the General Statutes is amended by adding a new 1
Article 11C to be entitled "Fair Billing and Collections Practices for Hospitals and Ambulatory 2
Surgical Facilities." 3
SECTION 2.(b) G.S. 131E-91 is recodified as G.S. 131E-214.50 under Article 11C 4
of Chapter 131E of the General Statutes, as created by subsection (a) of this section. 5
SECTION 2.(c) G.S. 131E-214.50(d) reads as rewritten: 6
"(d) Hospitals and ambulatory surgical facilities shall abide by the following reasonable 7
collections practices: 8
… 9
(1a) A hospital or ambulatory surgical facility shall not refer a patient's unpaid bill 10
to a collections agency, entit y, or other assignee unless it has first presented 11
an itemized list of charges to the patient detailing, in language comprehensible 12
to an ordinary layperson, the specific nature of the charges or expenses 13
incurred by the patient. 14
…." 15
SECTION 2.(d) Article 11C of Chapter 131E of the General Statutes, as created by 16
subsection (a) of this section, is amended by adding a new section to read: 17
"§ 131E-214.52. Patient's right to a good-faith estimate. 18
(a) Definitions. – The following definitions apply in this section: 19
(1) CMS. – The federal Centers for Medicare and Medicaid Services. 20
(2) Facility. – A hospital or ambulatory surgical facility licensed under this 21
Chapter. 22
(3) Items and services. – All items and services, including individual items and 23
services and service packages, that could be provided by a facility to a patient 24
in connection with an inpatient admission or an outpatient visit for which the 25
facility has established a standard charg e. Examples include, but are not 26
limited to, all of the following: 27
a. Supplies and procedures. 28
b. Room and board. 29
c. Fees for use of the facility or other items. 30
d. Professional charges for s ervices of physicians and nonphysician 31
practitioners who are employed by the facility. 32
e. Professional charges for services of physicians and nonphysician 33
practitioners who are not employed by the facility. 34
f. Any other items or services for which a facility has established a 35
standard charge. 36
(4) Service package. – An aggregation of individual items and services into a 37
single service with a single charge. 38
(5) Shoppable service. – A non-urgent service that can be scheduled by a patient 39
in advance. The term includes all CMS -specified shoppable services plus as 40
many add itional facility -selected shoppable services as are necessary for a 41
combined total of at least 300 shoppable services. 42
(b) Good-Faith Estimate. – Upon request of any patient for a good -faith estimate for a 43
shoppable service, the facility shall provide to the patient, in writing, at least three business days 44
prior to the date the patient schedules the shoppable service, an itemized list of expected charges, 45
in language comprehensible to an ordinary layperson, that the patient will be obligated to pay for 46
all items and services related to the shoppable service. The good-faith estimate shall include the 47
Diagnostic Related Group (DRG ), Current Procedural Terminology (CPT), or Healthcare 48
Common Procedure Coding System (HCPCS) code for each expected charge. 49
General Assembly Of North Carolina Session 2025
House Bill 192-Third Edition Page 3
(c) In any case in which a patient has requested a good -faith estimate from a facility for 1
a shoppable service, the patient's final bill for that shoppable service shall not exceed more than 2
five percent (5%) of the good-faith estimate provided to the patient pursuant to this section. 3
(d) The Department shall adopt rules to implement this section." 4
SECTION 2.(e) Subsections (a) through (e) of this section become effective on the 5
later of January 1, 2026, or the date the rules adopted by the Department under G.S. 131E-214.52 6
take effect and apply to acts occurring on or after that date. The Department shall notif y the 7
Revisor of Statutes when the rules required under G.S. 131E-214.52 take effect. 8
9
STATE BUDGET ACT APPLICABILITY 10
SECTION 3. If any provision of this act and G.S. 143C-5-4 are in conflict, the 11
provisions of this act shall prevail. The appropriations a nd the authorizations to allocate and 12
spend funds which are set out in this act shall remain in effect until the Current Operations 13
Appropriations Act for the applicable fiscal year becomes law, at which time that act shall 14
become effective and shall gover n appropriations and expenditures. When the Current 15
Operations Appropriations Act for that fiscal year becomes law, the Director of the Budget shall 16
adjust allotments to give effect to that act from July 1 of the fiscal year. 17
18
SEVERABILITY CLAUSE 19
SECTION 4 . If any provision of this act or its application is held invalid, the 20
invalidity does not affect other provisions or applications of this act that can be given effect 21
without the invalid provisions or application and, to this end, the provisions of this act are 22
severable. 23
24
EFFECTIVE DATE 25
SECTION 5. Except as otherwise provided, this act is effective retroactively to July 26
1, 2025. 27