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SB 859

Home Dialysis Accessibility Act.

2025-2026 Session Introduced by Jim Burgin and 1 co-sponsor

North Carolina health plans must cover dialysis in all settings, including home dialysis, and staff-assisted home dialysis for certain disabilities starting Oct 1, 2026.

Passed 1st Reading
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Bill Summary · SB 859

Summary of S.B. 859 (Session 2025) — North Carolina: Home Dialysis Accessibility Act

Overview

S.B. 859, titled the Home Dialysis Accessibility Act, is a North Carolina Senate bill sponsored by Senator Burgin. The bill aims to increase access to dialysis treatment by ensuring health benefit plans cover dialysis services in all settings, including home dialysis, and by requiring coverage of staff-assisted home dialysis for specific populations. It also provides state plan integration and a small state-funded implementation appropriation.

Purpose and Intent

  • Expand coverage to include dialysis services (hemodialysis and peritoneal dialysis) across all settings, with explicit inclusion of home-based dialysis.
  • Improve access for individuals who require assistance with home dialysis due to certain disabilities or impairments.
  • Align state health plans with the broadened coverage requirements and fund implementation activities.

Key Provisions

Section 1: Coverage of Dialysis (new § 58-3-257)

  • Health benefit plans offered in North Carolina that cover hemodialysis, peritoneal dialysis, or both must provide coverage for these services in all settings, explicitly including home dialysis.
  • Requires coverage for staff-assisted home dialysis furnished by trained professionals for individuals who meet any of the following criteria:
    1. Blind or visually impaired.
    2. Cognitive or neurological impairment.
    3. Any illness or injury that reduces mobility.

Section 1(b): Effective Date for Coverage Mandate

  • The dialysis coverage provision becomes effective October 1, 2026.
  • Applies to insurance contracts issued, renewed, or amended on or after that date.

Section 2: State Health Plan Alignment (amendments to § 135-48.51)

  • The State Health Plan is required to apply the same dialysis coverage requirements (as described in § 58-3-257) when managing health benefits and operations.
  • Effective Date: Applies to the start of the next plan year following October 1, 2026.

Section 3: Appropriation

  • A recurring appropriation of $100,000 from the General Fund to the State Treasurer.
  • Purpose: To implement the coverage requirements established in Section 2.
  • Effective July 1, 2026, with funds available for the 2026-2027 fiscal year onward.

Section 4: General Provision

  • Except as otherwise provided, the act becomes effective when it becomes law.

Affected Parties

  • Individuals enrolled in health benefit plans in North Carolina that cover dialysis (hemodialysis and/or peritoneal dialysis), who will gain coverage for dialysis services in home and other settings.
  • Individuals requiring staff-assisted home dialysis due to visual impairment, cognitive/neurological impairment, or mobility-reducing illnesses/injuries.
  • State Health Plan participants and administrators, who must implement the same coverage requirements.
  • Employers and insurers offering affected plans, who will need to ensure compliance with the new scope of dialysis coverage.

Procedural and Timeline Considerations

  • October 1, 2026: Primary coverage mandate for dialysis in all settings (including home dialysis) and staff-assisted home dialysis becomes effective for new or revised contracts.
  • Start of the next plan year after October 1, 2026: State Health Plan must apply the dialysis coverage requirements.
  • July 1, 2026: Appropriation of $100,000 from the General Fund to support implementation.
  • The act provides a framework for coverage but relies on regulatory implementation and plan-level changes by insurers and the State Health Plan.

Practical Impact

  • Broadens access to home-based dialysis as a covered service under applicable health plans.
  • Specifically assists individuals with impairments that make home dialysis more viable or necessary, by mandating coverage of staff-assisted home dialysis when criteria are met.
  • Requires state health programs to reflect these coverage changes and provides limited funding to facilitate implementation.

If you’d like, I can add a plain-language FAQ or compare these provisions to current NC dialysis coverage rules.

Compiled from official sources — confirm details with the bill’s official record.

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