North Carolina Sen. Sawrey’s Medicaid regulation amendment bill passes House and Senate

Passed bill sponsored by State Sen. Sawrey aims to update Medicaid eligibility and managed care enrollment procedures and align state provider screening laws with federal standards after incarceration, according to the North Carolina State Senate.

In the House, 49 Democrats and 62 Republicans voted in favor of the bill.

Meanwhile, in the Senate, 17 Democrats and 29 Republicans voted in favor of the bill.

Sawrey filed the bill in the North Carolina Senate on March 25 during the 2025 regular session.

The legislation, known as SB 600, was passed on June 24 during the 2025 regular session.

According to the North Carolina General Assembly site, the bill’s official text was formally listed with the short title: “Medicaid Agency Omnibus.”

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, this bill proposes amendments to various Medicaid-related regulations in North Carolina. It extends the temporary use of the federally facilitated marketplace for Medicaid eligibility determinations until June 30, 2028. The bill also clarifies enrollment procedures for Medicaid managed care following an individual’s release from incarceration, stating that the Medicaid exception for inmates will continue until the first day of the month after their twelfth month post-release. Additionally, it aligns state laws with federal requirements concerning Medicaid provider screenings by categorizing various provider types according to risk levels. The bill further establishes subrogation rights for Medicaid claims in managed care settings, outlining the distribution of recovery proceeds and detailing beneficiary rights to court proceedings to dispute presumed recovery distributions. Sections of the bill have retroactive effective dates, specifically to January 1, 2023, and January 1, 2024, depending on the amendment. The act becomes law upon passage, with the effective date specified for certain subsections.

The bill was sponsored by Sen. Jim Burgin (Republican-12th District), Sen. Amy S. Galey (Republican-25th District), and Sen. Benton G. Sawrey (Republican-10th District).

Bills in North Carolina follow a multi-step process before becoming law. A lawmaker starts by filing a bill, which is assigned to a committee for review. The bill must be read three times in each chamber. If one chamber changes the bill after the other passes it, both must agree on the final version. Once both chambers approve the same bill, it goes to the governor, who has 10 days (or 30 if the legislature is not in session) to sign, veto, or let it become law without a signature.

You can read more about the bills and other measures here.

Sawrey graduated from North Carolina State University in 2009 with a BA and again in 2013 from University of South Carolina School of Law with a JD.

Sawrey, a Republican, was elected to the North Carolina State Senate in 2023 to represent the state’s 10th Senate district, replacing previous state senator Brent Jackson.

Under North Carolina law, bills must receive three readings in each chamber. According to the UNC School of Government, once a bill “passes its constitutionally required second reading and moves to its constitutionally required third reading,” additional debate can occur, but the final stage is often treated as a formality. Unless a legislator requests a roll-call, the third reading may be approved by voice vote or unanimous consent without a separate recorded tally.