The civic record
Read. Follow. Verify.North Carolina requires health plans to cover prosthetic and orthotic devices and care
Last action · May 7, 2025: Ref To Com On Rules and Operations of the Senate (Senate action)Sponsors: John Bell and 21 others
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What This Bill Would Do
North Carolina mandates that health benefit plans cover prosthetic and orthotic devices, materials, components, repairs, and replacements based on medical necessity starting October 1, 2025. Insurers are prohibited from denying claims for individuals with disabilities that would be covered for persons without disabilities seeking the same physical activities. Additionally, the measure repeals state-level emergency care coverage requirements that duplicate federal law.
Insured residents with limb loss or limb difference gain guaranteed insurance coverage for multiple prosthetic devices, replacement parts without lifetime restrictions, and physical activity support. Insurers must report claims data to state officials by early 2028.
- State legislatures frequently introduce insurance mandate bills to standardize coverage requirements across commercial health plans for specific medical conditions and devices. context
Who It Would Affect
Groups the bill's text would affect if enacted, as described in the record. Being affected is not a position for or against it.
North Carolinians with limb loss and limb difference
Guaranteed health plan coverage for medically necessary prosthetic and orthotic devices, repairs, replacements, and physical activity equipment.
Health benefit plan insurers
Must provide required prosthetic and orthotic coverage, comply with replacement rules, and report claims data to the Insurance Commissioner by 2028.
Prescribing healthcare providers
Determine the medical appropriateness of prosthetic models and provide necessary clinical confirmations for device replacements under three years old.
Key Facts
You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.
Frequently Asked Questions
What types of activities must health plans cover additional prosthetic devices for?
When can an insurer require confirmation from a healthcare provider before replacing a device?
When does this requirement take effect for health insurance policies?
What else do you want to know?
News Coverage
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Votes, people, money & the original sourceWhere This Stands
Currently passed chamber. The next step in the legislative lifecycle is Law.
Procedural history
16 actions- May 7, 2025SenateRef To Com On Rules and Operations of the Senate
- May 7, 2025SenatePassed 1st Reading
- May 7, 2025SenateRegular Message Received From House
- May 7, 2025HouseRegular Message Sent To Senate
- May 6, 2025HousePassed 3rd Reading
- May 6, 2025HousePassed 2nd Reading
Show 10 earlier actions
- May 1, 2025HousePlaced On Cal For 05/06/2025
- May 1, 2025HouseCal Pursuant Rule 36(b)
- May 1, 2025HouseReptd Fav
- Apr 30, 2025HouseRe-ref Com On Rules, Calendar, and Operations of the House
- Apr 30, 2025HouseReptd Fav
- Apr 29, 2025HouseRe-ref Com On Insurance
- Apr 29, 2025HouseReptd Fav Com Substitute
- Apr 14, 2025HouseRef to the Com on Health, if favorable, Insurance, if favorable, Rules, Calendar, and Operations of the House
- Apr 14, 2025HousePassed 1st Reading
- Apr 10, 2025HouseIntroducedFiled
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Sponsors
Show 17 more sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Expansion of Mandated Prosthetic Coverage
The measure shifts North Carolina insurance rules to explicitly tie mandatory prosthetic coverage standards to federal Medicare Part B regulations while eliminating continuous-use restrictions.
Connected Entities
Sources
www.ncleg.gov
Analysis Score
0–100- Significance75How much this matters to a regular citizen
- Controversy25Intensity of disagreement among stakeholders
- Entertainment5Compellingness for a non-policy-wonk reader
- Buzz35Current news / social attention level
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