North Carolina 2025 Session Status: In Committee Bipartisan · 1 D · 1 R cosponsors

SB 672 — Protect North Carolinians from Medical Debt.

Last action — Passed 1st Reading

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  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed House
  5. 5
    To Executive
  6. 6
    Enacted

This bill is in committee in the Senate. Introduced March 25, 2025. It must pass committee before a floor vote.

Next likely step: a committee vote, then a floor vote in the Senate.

Prognosis

Advancing 34% · moderate confidence

Where this bill stands today.

Odds of enactment

Low

How often bills like it became law.

  • In Committee

    Current position in the legislative process.

  • 2 sponsors

    0 primary, 2 co-sponsors signed on.

  • Bipartisan support

    Sponsored across 2 parties (1 D · 1 R) — cross-party backing.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Bill Text

What changed in the latest version

43 added · 44 removed

Plain-language change summary

In the updated version of Senate Bill 672, language regarding the responsibilities of healthcare facilities has been clarified to better outline their financial assistance policies for patients. One key change is the requirement for large healthcare facilities to include specific language in their notices, ensuring patients understand their financial rights. This matters because it aims to improve transparency and protect patients from unexpected medical debt while ensuring they are informed about their options for assistance.

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FILED SENATE GENERAL ASSEMBLY OF NORTH CAROLINA Mar 25, 2025 S.B.
GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2025 S 1 SENATE BILL 672 Short Title:
672 SESSION 2025 PRINCIPAL CLERK S D SENATE BILL DRS45310-NH-20 Short Title:
A BILL TO BE ENTITLED AN ACT TO ADOPT THE PRO-FAMILY, PRO-CONSUMER MEDICAL DEBT PROTECTION ACT TO LIMIT THE ABILITY OF LARGE MEDICAL FACILITIES TO CHARGEUNREASONABLE INTERESTRATES ANDEMPLOY UNFAIR TACTICS IN DEBT COLLECTION.
Rules and Operations of the Senate March 26, 2025 A BILL TO BE ENTITLED AN ACT TO ADOPT THE PRO-FAMILY, PRO-CONSUMER MEDICAL DEBT PROTECTION ACT TO LIMIT THE ABILITY OF LARGE MEDICAL FACILITIES TO CHARGEUNREASONABLE INTERESTRATES ANDEMPLOY UNFAIR TACTICS IN DEBT COLLECTION.
*DRS45310-NH-20* General Assembly Of North Carolina Session 2025 a.
*S672-v-1* General Assembly Of North Carolina Session 2025 a.
– A covered health care provider's full, established price for health care services that the covered health care provider charges uninsured patients before applying any contractual allowances, discounts, or deductions.
– A covered health care provider's full, established price for health care services that the covered health care provider charges uninsured patients before applying anycontractual allowances, discounts, or deductions.
Any practice which provides outpatient medical, behavioral, optical, radiology, laboratory, dental, or other health care services with revenues of at least twenty million dollars ($20,000,000) annually and Page 2 DRS45310-NH-20 General Assembly Of North Carolina Session 2025 is licensed under this Chapter or has medical providers performing health care services pursuant to a license issued under Chapter 90 of the General Statutes.
Any practice which provides outpatient medical, behavioral, optical, radiology, laboratory, dental, or other health care services with revenues of at least twenty million dollars ($20,000,000) annually and Page 2 Senate Bill 672-First Edition General Assembly Of North Carolina Session 2025 is licensed under this Chapter or has medical providers performing health care services pursuant to a license issued under Chapter 90 of the General Statutes.
– Any entity that provides health care services and to whom the consumer owes money for health care services, or the entity that provided health care services and to whom the consumer previously owed money if the medical debt has been purchased by one or more debt buyers.
– Any entitythat provides health care services and to whom the consumer owes money for health care services, or the entity that provided health care services and to whom the consumer previously owed money if the medical debt has been purchased by one or more debt buyers.
– Any person that regularly collects or attempts to collect, directly or indirectly, medical debts originally owed or due or asserted to be owed or due another.
– Any person that regularly collects or attempts to collect, directlyor indirectly, medical debts originallyowed or due or asserted to be owed or due another.
DRS45310-NH-20 Page 3 General Assembly Of North Carolina Session 2025 (11) Measures the facility will take to widely publicize the policy within the community to be served by the facility in accordance with G.S.
Senate Bill 672-First Edition Page 3 General Assembly Of North Carolina Session 2025 (11) Measures the facility will take to widely publicize the policy within the community to be served by the facility in accordance with G.S.
If the patient submits a financial assistance application to a medical debt collector, the medical debt collector shall forward the application to the large health care facility within two business days Page 4 DRS45310-NH-20 General Assembly Of North Carolina Session 2025 and shall cease collection activity until notified by the large health care facility of the outcome of the application and any debt forgiven or new repayment terms.
If the patient submits a financial assistance application to a medical debt collector, the medical debt collector shall forward the application to the large health care facility within two business days Page 4 Senate Bill 672-First Edition General Assembly Of North Carolina Session 2025 and shall cease collection activity until notified by the large health care facility of the outcome of the application and any debt forgiven or new repayment terms.
(a) As part of a large health care facility's MDMP, the facility shall adopt a process to screen for presumptive eligibility for financial assistance and establish a process for determining DRS45310-NH-20 Page 5 General Assembly Of North Carolina Session 2025 non-presumptive eligibility.
(a) As part of a large health care facility's MDMP, the facility shall adopt a process to screen for presumptive eligibility for financial assistance and establish a process for determining Senate Bill 672-First Edition Page 5 General Assembly Of North Carolina Session 2025 non-presumptive eligibility.
(3) Shall allow patients to attest to their qualifications for Medicaid, with an understanding that the patient will not be financially penalized for misreporting qualifications ifthe reportwas made in goodfaithandthepatient is later determined to be ineligible.
(3) Shall allow patients to attest to their qualifications for Medicaid, with an understanding that the patient will not be financially penalized for misreportingqualifications ifthe reportwas made in goodfaith and thepatient is later determined to be ineligible.
The patient or someone in the patient's household is enrolled in any means-tested public assistance program, including Supplemental Security Income,MedicareLowIncomeSubsidy,LowIncomeEnergy Assistance Program, Temporary Assistance to Needy Families, Women, Infants and Children Nutrition Program, or Supplemental Nutrition Assistance Program.
The patient or someone in the patient's household is enrolled in any means-tested public assistance program, including Supplemental SecurityIncome,MedicareLowIncomeSubsidy,Low IncomeEnergy Assistance Program, Temporary Assistance to Needy Families, Women, Infants and Children Nutrition Program, or Supplemental Nutrition Assistance Program.
(c) If a patient is found to not be presumptively eligible for financial assistance after being screened in accordancewith subsection(b)of this section, thenthelargehealthcare facility must provide a process for patients to apply for financial assistance that complies with all of the following:
(c) If a patient is found to not be presumptively eligible for financial assistance after beingscreened in accordancewith subsection(b)of this section, thenthelargehealthcare facility must provide a process for patients to apply for financial assistance that complies with all of the following:
Page 6 DRS45310-NH-20 General Assembly Of North Carolina Session 2025 b.
Page 6 Senate Bill 672-First Edition General Assembly Of North Carolina Session 2025 b.
Any documentation of household income which the Office of the State Treasurer has identified as a valid form of documentation for the purposes of this Article.
Anydocumentation of household income which the Office of the State Treasurer has identified as a valid form of documentation for the purposes of this Article.
Forhospitals,displaysshouldbepostedintheemergencyroom, DRS45310-NH-20 Page 7 General Assembly Of North Carolina Session 2025 if any, billing and financial assistance application areas, and admissions areas, at a minimum.
Forhospitals,displaysshouldbepostedintheemergencyroom, Senate Bill 672-First Edition Page 7 General Assembly Of North Carolina Session 2025 if any, billing and financial assistance application areas, and admissions areas, at a minimum.
The notification must inform the patient that by using a credit card to pay for medical services, the patient may be forgoing state and federal protections regarding medical debt and financial assistance policies.
The notification must inform the patient that by using a credit card to pay for medical services, the patient may be forgoing state and federal protections regardingmedical debt and financial assistance policies.
(e) A large healthcare provider may not require a credit card pre-authorization or for a patient to have a credit card on file prior to providing emergency or medically necessary services to a patient.
(e) A large healthcare provider may not require a credit card pre-authorization or for a patient to have a credit card on file prior to providing emergencyor medically necessary services to a patient.
(a) Notices sent by large health care facilities shall include the following language:
(a) Notices sent bylarge health care facilities shall include the following language:
A large health care facility may determine the percentage or number of limited English proficiency individuals in thelargehealth carefacility's communityorlikely to beaffected orencounteredbythehospital facility.
A large health care facility may determine the percentage or number of limited English proficiency individuals in thelargehealth carefacility's communityorlikelyto beaffectedorencountered bythehospital facility.
Page 8 DRS45310-NH-20 General Assembly Of North Carolina Session 2025 (c) A large health care facility must accommodate any patient with limited English proficiency, who is part of a population which falls below the numerical thresholds established in subsection (b) of this section, by providing oral interpretation services to the patient upon request and at no cost to the patient to explain the MDMP and its application.
Page 8 Senate Bill 672-First Edition General Assembly Of North Carolina Session 2025 (c) A large health care facility must accommodate any patient with limited English proficiency, who is part of a population which falls below the numerical thresholds established in subsection (b) of this section, by providing oral interpretation services to the patient upon request and at no cost to the patient to explain the MDMP and its application.
(a) No medical creditor or medical debt collector shall engage in any permissible extraordinary collection actions until 180 days after the first bill for a medical debt has been sent.
(a) No medical creditor or medical debt collector shall engage in any permissible extraordinarycollection actions until 180 days after the first bill for a medical debt has been sent.
(d) At least 30 days before taking any extraordinary collection actions, a medical creditor or medical debt collector must provide to the patient a notice containing the following:
(d) At least 30 days before taking anyextraordinarycollection actions, a medical creditor or medical debt collector must provide to the patient a notice containing the following:
DRS45310-NH-20 Page 9 General Assembly Of North Carolina Session 2025 (4) Identifying unlawful debt collection actions and practices that the medical creditor or debt collector are barred from taking or conducting under state and federal law, including causing an individual's arrest, holding a spouse liable for an individual's medical debt, foreclosing on an individual's property, and garnishing wages or state income tax refunds and shall provide information about filing a complaint with the Attorney General if a patient's rights are violated.
Senate Bill 672-First Edition Page 9 General Assembly Of North Carolina Session 2025 (4) Identifying unlawful debt collection actions and practices that the medical creditor or debt collector are barred from taking or conducting under state and federal law, including causing an individual's arrest, holding a spouse liable for an individual's medical debt, foreclosing on an individual's property, and garnishing wages or state income tax refunds and shall provide information about filing a complaint with the Attorney General if a patient's rights are violated.
(e) A large health care facility or a medical debt collector collecting debt for health care services provided by such afacilityshall not useanyextraordinary collectionactions unless these actions are described in the large health care facility's billing and collections policy.
(e) A large health care facility or a medical debt collector collecting debt for health care services provided bysuch afacilityshall not useanyextraordinarycollectionactions unless these actions are described in the large health care facility's billing and collections policy.
(f) If a large health care facility or a medical debt collector collecting debt for health care services provided by such a facility bills or initiates collection activities and the patient is later found eligible for financial assistance, within 90 days from the date eligibility is determined the large health care facility or medical debt collector shall reverse any extraordinary collection actions, including dismissing or vacating any collection lawsuits over the medical debt and returning any funds or property taken as part of judgment enforcement.
(f) If a large health care facilityor a medical debt collector collecting debt for health care services provided by such a facility bills or initiates collection activities and the patient is later found eligible for financial assistance, within 90 days from the date eligibility is determined the large health care facility or medical debt collector shall reverse any extraordinary collection actions, including dismissing or vacating any collection lawsuits over the medical debt and returning any funds or property taken as part of judgment enforcement.
Page 10 DRS45310-NH-20 General Assembly Of North Carolina Session 2025 (7) Any adjustment to the bill, including negotiated insurance rates or other discounts.
Page 10 Senate Bill 672-First Edition General Assembly Of North Carolina Session 2025 (7) Any adjustment to the bill, including negotiated insurance rates or other discounts.
(b) No medical creditor that knows or should have known about an internal review, external review,orother appealofahealthinsurancedecisionthatispendingnoworwas pending within the previous 180 days shall refer, place, or send the unpaid charges for health care services to a medical debt collector, including by selling the debt to a medical debt buyer.
(b) No medical creditor that knows or should have known about an internal review, externalreview,orother appealofahealthinsurancedecisionthatispendingnoworwaspending within the previous 180 days shall refer, place, or send the unpaid charges for health care services to a medical debt collector, including by selling the debt to a medical debt buyer.
This plan shall prominently disclose the rate of any interest being applied to thedebt in compliancewith G.S.
This plan shall prominently disclose the rate of anyinterest being applied to thedebt in compliancewith G.S.
DRS45310-NH-20 Page 11 General Assembly Of North Carolina Session 2025 Additionally, notice must be provided in writing that the payment plan may become inoperative and informing thepatient oftheopportunity to renegotiatethepayment plan.
Senate Bill 672-First Edition Page 11 General Assembly Of North Carolina Session 2025 Additionally, notice must be provided in writing that the payment plan may become inoperative and informingthepatient oftheopportunityto renegotiatethepayment plan.
(e) Apayment plan shall not includeanypenaltiesor fees forprepayment, early payment, or early payoff.
(e) Apayment plan shall not includeanypenaltiesor fees forprepayment, earlypayment, or early payoff.
Page 12 DRS45310-NH-20 General Assembly Of North Carolina Session 2025 (2) Multiple or minimum damages as specified by statute.
Page 12 Senate Bill 672-First Edition General Assembly Of North Carolina Session 2025 (2) Multiple or minimum damages as specified by statute.
(b) The Attorney General shall establish a complaint process allowing an aggrieved patient orany memberof thepublicto fileacomplaint against amedical creditorordebt collector who violates any provision of this Article.
(b) The Attorney General shall establish a complaint process allowing an aggrieved patient oranymemberof thepublicto fileacomplaint against amedical creditorordebt collector who violates any provision of this Article.
(c) The Department shall consult with North Carolina's Medical Care Advisory Committee, Beneficiary Advisory Council, and Medicaid Advisory Council to develop materials to inform the public about MDMP policies.
(c) The Department shall consult with North Carolina's Medical Care Advisory Committee, Beneficiary AdvisoryCouncil, and Medicaid Advisory Council to develop materials to inform the public about MDMP policies.
(5) Thestatutory eligibilityandrequirementsforfinancialassistanceandpayment plans.
(5) Thestatutoryeligibilityandrequirementsforfinancialassistanceandpayment plans.
DRS45310-NH-20 Page 13 General Assembly Of North Carolina Session 2025 (5) The total amount of financial assistance provided to patients based on a cost to charge ratio and Medicare reimbursement rates.
Senate Bill 672-First Edition Page 13 General Assembly Of North Carolina Session 2025 (5) The total amount of financial assistance provided to patients based on a cost to charge ratio and Medicare reimbursement rates.
For any school of medicine, clinical program, facility, or practice affiliated with one of the constituent institutions of The University of North Carolina that provides medical care to the general public and for The University of North Carolina Health Care System and other persons or entities affiliated with or under the control of The University of North Carolina Health Care System, the term "debt" is limited to the sum owed to one of these entities by law or by contract Page 14 DRS45310-NH-20 General Assembly Of North Carolina Session 2025 following adjudicationof a claim resulting from an individual's receipt of hospital or medical services at a time when the individual was covered by commercial insurance, Medicaid, Medicare, Medicare Advantage, a Medicare supplement plan, or any other government insurance." 7 PART IV.
For any school of medicine, clinical program, facility, or practice affiliated with one of the constituent institutions of The University of North Carolina that provides medical care to the general public and for The University of North Carolina Health Care System and other persons or entities affiliated with or under the control of The University of North Carolina Health Care System, the term "debt" is limited to the sum owed to one of these entities by law or by contract Page 14 Senate Bill 672-First Edition General Assembly Of North Carolina Session 2025 following adjudicationof a claim resulting from an individual's receipt of hospital or medical services at a time when the individual was covered by commercial insurance, Medicaid, Medicare, Medicare Advantage, a Medicare supplement plan, or any other government insurance." 7 PART IV.
DRS45310-NH-20 Page 15
Senate Bill 672-First Edition Page 15
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How this bill changes current law

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AI-generated reading aid from the bill's amendatory text — verify against the official bill.

The bill establishes the Medical Debt Protection Act, which adds protections for consumers regarding medical debt collection practices and requires large health care facilities to implement written financial assistance policies.

  • Chapter 131E

    Article 11C. Medical Debt Protection Act.

    Creates a new article within Chapter 131E focused on medical debt protection.

  • § 131E-214.21

    The purpose of this Article is to reduce burdensome medical debt and to protect patients in their dealings with medical creditors, medical debt buyers, and medical debt collectors with respect to such debt.

    Establishes the intent of the Medical Debt Protection Act.

  • § 131E-214.22

    Definitions applicable in this Article, including 'Consumer', 'Medical creditor', and 'Medical debt'.

    Introduces key definitions needed for the bill's implementation.

  • § 131E-214.23

    Large health care facilities are required to develop a written MDMP that complies with this Article and any implementing rules.

    Mandates large health care facilities to create financial assistance policies.

  • § 131E-214.23(b)

    The MDMP must, at a minimum, include a written financial assistance policy for emergency and medically necessary health care services.

    Ensures financial assistance policies cover essential health care services.

  • § 131E-214.23(c)

    The MDMP must be approved by the owners or governing body of a health care provider and shall be reviewed by the owners or governing board annually.

    Establishes accountability for MDMP approval and annual review.

  • § 131E-214.24

    Large health care facilities must determine whether a patient has health insurance before seeking payment for emergency or medically necessary care.

    Requires insurance status verification prior to debt collection.

  • § 131E-214.24(2)

    If the patient is uninsured, offer to screen the patient for public or private insurance eligibility.

    Mandates assistance with insurance applications for uninsured patients.

  • § 131E-214.24(6)

    The large health care facility shall issue a determination of eligibility on the application or eligibility documentation within 14 days.

    Sets a timeline for eligibility determination to expedite patient support.

  • § 131E-214.24(7)

    A large health care facility shall provide a patient notifications regarding their financial assistance application status.

    Ensures patients are informed throughout the financial assistance process.

Action History

  1. Passed 1st Reading

  2. Ref To Com On Rules and Operations of the Senate

  3. Filed

Sponsors

Sponsorship breakdown

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0 sponsors · 2 co-sponsors · 177 not signed on

Sponsors (0)

None.

Co-sponsors (2)

Not signed on (177)

177 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

finance healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

Who sponsors SB 672?
SB 672 is sponsored by Julie Mayfield (Democratic) and Jim Burgin (Republican).
What is the current status of SB 672?
This bill is in committee in the Senate. Introduced March 25, 2025. It must pass committee before a floor vote.
Where can I track SB 672?
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