North Carolina legislation · 2025-2026 Session
North Carolina S315: More Transparency/Efficiency in Utiliz. Rev.
Status: In committee, March 18, 2025
What the bill says
An act to increase transparency and efficiency in utilization reviews.
From the introduced text:
A BILL TO BE ENTITLED AN ACT TO INCREASE TRANSPARENCY AND EFFICIENCY IN UTILIZATION REVIEWS. The General Assembly of North Carolina enacts: SECTION 1.(a) G.S. 58-50-61 reads as rewritten: "§ 58-50-61. Utilization review. (a) Definitions. - As used The following definitions apply in this section, in G.S. 58-50-62, and in Part 4 of this Article, the term:Article: ... (16a) Urgent health care service. - A health care service with respect to which the application of the time periods for making an urgent care determination that, in the opinion of a physician with knowledge of the covered person's medical condition, meets either of the following criteria: a. Could seriously jeopardize the life or health of the covered person or the ability of the covered person to regain maximum function. b. Would subject the covered person to severe pain that cannot be adequately managed without the care or treatment that is the subject of the utilization review. ... (f) Time Lines for Prospective and Concurrent Utilization Reviews Based Upon Type of Health Care Service. - As used in this subsection, the term "necessary information" includes the results of any patient examination, clinical evaluation, or second opinion that may be required. Prospective and concurrent determinations shall be communicated to The time line for completion of a prospective or concurrent utilization review is as …
Sponsors
- Burgin, Jim (R, 12) · primary sponsor
- Galey, Amy S. (R, 25) · primary sponsor
- Sawrey, Benton G. (R, 10) · primary sponsor
- Alexander, W. Ted (R, 44)
- Brinson, Bob (R, 3)
- Ford, Carl (R, 33)
- Hanig, Bobby (R, 1)
- Hise, Ralph (R, 47)
- Hollo, Mark (R, 45)
- Jackson, Brent (R, 9)
- Jones, Dana (R, 31)
- Lee, Michael V. (R, 7)
Latest actions
- : Ref to Health Care. If fav, re-ref to Rules and Operations of the Senate
- : Passed 1st Reading
- : Filed
Subjects: COUNCIL OF STATE, MENTAL HEALTH, STATE HEALTH DIRECTOR, STATE HEALTH PLAN, DHHS, STATE EMPLOYEES, HEALTH SERVICES, INSURANCE
Common questions
- What is S315?
- S315 is a bill in the North Carolina Legislature (2025-2026 Session): More Transparency/Efficiency in Utiliz. Rev.
- What does S315 do?
- In its own words: An act to increase transparency and efficiency in utilization reviews.
- What is the status of S315?
- In committee as of March 18, 2025. Latest action: Ref to Health Care. If fav, re-ref to Rules and Operations of the Senate (March 18, 2025).
- Who sponsored S315?
- Burgin, Jim (R, 12), with 11 co-sponsors.
- Where is the official record for S315?
- On the North Carolina Legislature website: https://www.ncleg.gov/BillLookUp/2025/S315
Source: official North Carolina record. Tracked by Delilah, AI for legislation across all 50 states and Congress.