An N.C. Senate health-care bill that has evolved into a clearinghouse for patient care and evaluation issues received final approval Monday in the House.

The vote was 106-3 on the third reading in favor of Senate Bill 361, titled “Healthy NC.” The bill was approved 114-3 on second reading Wednesday.

The bill returns to the Senate for concurrence on several House changes.

Pieces of five House health bills have been added to SB361. Those House bills were stalled in the Senate Rules and Operations Committee.

SB361’s sponsors don’t appear to have any objections to the House additions, with the possible exception of language that deals with the types and costs of medication available for cancer treatments.

There was an attempt Monday to add a sixth new section to aimed to increase transparency in pricing of prescription drugs.

The amendment had two key elements: addressing a manufacturer’s ability to raise its cost by more than 10% in a 12-month period; and requiring a manufacturer to provide at least a 60-day notice of a price increase. The amendment was voted down 57-51.

The bill would regulate medication used to treat cancer, including putting oral medication on an equal basis with treatment in a medical facility.

State Rep. Verla Insko, D-Orange, has expressed concern that equal treatment could cause insurance premiums to go up because oral chemotherapy drugs tend to be more costly.

Supporters of folding House Bill 480 into SB361 said cancer patients should be allowed another option besides going to a medical facility for injected medicine.

SB361 was initially known foremost for containing controversial language that would have eliminated state laws governing certificates of need, or CON, that state regulators issue to allocate new health-care facilities.

The CON language was watered down, and then eventually removed by one of SB361’s sponsors, state Sen. Joyce Krawiec, R-Forsyth, to ensure Senate passage of the other legislation. The bill passed the Senate on a 48-0 vote June 26.

The bill’s primary focus now is on allowing licensed marriage and family therapists to conduct initial examinations for involuntary commitments.

The goal is alleviating a shortfall of medical providers who are qualified to conduct an examination. According to Krawiec, there are about 90 qualified medical providers statewide.

Adding licensed marriage and family therapists to conduct initial exams, Krawiec said, could accelerate the review process “so that individuals don’t have to stay for days in a hospital emergency department awaiting care and review.”

Krawiec said that in many hospitals, there remains a shortage of psychiatric beds for people who are involuntary committed.

Another key element of SB361 would allow North Carolina to become the eighth state to join a national psychology licensure compact.

The bill also would eliminate redundancy in adult-care home inspections; provide more support and set fees for expanding telehealth services; and create a task force to handle certain health-care access issues over a 10-year period.

“The language would make telehealth more efficient and more accessible and hopefully at a lower (per visit) fee because there is less brick-and-mortar involved,” said state Rep. Donny Lambeth, R-Forsyth.

Another component added to SB361 is from HB450, which deals with “step therapy,” which require insurers to have patients try cheaper treatments before approving coverage for more expensive alternatives. The provision would add new protocols and directly affects State Health Plan participants.

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