STATE BUDGET

North Carolina enacts budgets on a two-year cycle, beginning July 1 of each odd-numbered year and valid through June 30 of the following odd-numbered year.

STATE LEGISLATURE

The North Carolina General Assembly is comprised of the Senate, with 50 members, and the House of Representative which has 120 members.  Members of both chambers serve two-year terms.  The General Assembly meets in regular session (the “long session”) starting in January of odd-numbered years, and meets for “short sessions” in even numbered years.  Typically, the long session lasts six months, and the short session for six weeks.  Bills carry over from odd to even numbered years.

KEY RESOURCES

• North Carolina General Assembly
• North Carolina Governor
• North Carolina Attorney General

NORTH CAROLINA KEY CASE

United States & North Carolina v. CHS (Atrium Health)
The DOJ and North Carolina AG filed a civil suit alleging that CHS (later Atrium Health) uses anticompetitive, illegal anti-steering clauses in its contracts with insurers, which prohibit commercial health insurers in the Charlotte area from offering patients financial benefits to use less-expensive healthcare services offered by CHS’s competitors. The parties reached a settlement in November 2018, which prohibits the provider from enforcing the anticompetitive clauses in contracts with insurers.  

For in-depth analysis of HCA’s Purchase of Mission Hospital, see Mark A. Hall’s original research on the subject.

2025 LEGISLATIVE SUMMARY

North Carolina enacted SB479, which imposed PBM reforms, including requiring state licensure, ownership disclosures, pharmacy audit protections, and pricing transparency. It also prohibits discriminatory reimbursement and pharmacy treatment practices, and mandates insurers to calculate patient cost-sharing based on actual drug prices after manufacturer rebates.