Bill > H634

This bill updates North Carolina's laws regarding mental health and substance use disorder benefits coverage to align more closely with federal parity requirements. The legislation makes several key changes to existing statutes, primarily focused on ensuring that health benefit plans provide coverage for mental health conditions that is equivalent to coverage for physical health conditions. The bill replaces outdated terminology like "chemical dependency" with "substance use disorder" and modifies definitions of mental health conditions. It requires that medical necessity determinations for mental health and substance use disorders be assessed using the same criteria as those for physical health conditions, specifically mandating the use of the most recent American Society of Addiction Medicine criteria for substance use disorders. The bill also clarifies that health benefit plans must comply with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 and its regulations. Additionally, the legislation updates utilization review practices to ensure that clinical review processes are consistent across mental and physical health conditions, prohibits incentive structures that might bias review decisions, and requires qualified healthcare professionals to administer these reviews. The changes will take effect on October 1, 2025, and will apply to insurance contracts issued, renewed, or amended on or after that date.

Health and Social Services

https://www.ncleg.gov/BillLookUp/2025/H634