House and Senate Budget Comparison

House Special Provisions for SB 257 – Appropriations Act of 2017

Differences Between the House and Senate Budget

Medicaid Overview:
Funds for Medicaid Management Information System (MMIS)/Analytics Reprocurement:The House’s budget provides the same total funding amounts as the Senate budget which include the following:

• FY 17-18 – $1,284,300
• FY 18-19 – $2,195,703

However, the House budget gives $142,700 in FY 17-18, and $243,967 in FY 18-19 in prior year earned revenues to determine enhancements needed to align MMIS and Reporting and Analytics with federal Medicaid Information Technology Architecture standards. In addition, the funds could be used for the procurement of a new MMIS contract and a new Reporting and Analytics contract. Finally, this portion states that the Department can create 10 full time equivalent time-limited positions dedicated to the projects.
Rural and Free Care:
Community Health Grant Program Changes:

• The House budget would give $15,000,000 to the Community Health Grants. It also designates specific funding for positions and awarding grants.

Rural Health Loan Repayment:

• Combines The Physician Loan Repayment Program, The Psychiatric Loan Repayment Program and The Loan Repayment Initiative at State Facilities.
• The funds also could be used to expand the Program to include eligible providers who use telemedicine in rural and underserved areas.
• The House budget gives the same amount of funding, $6,400,000, to achieve the required deduction in purchased services.

Certificate of Need:

• The House budget does not include the Certificate of Need provisions in the Senate.

Psychiatric and Facility-Based Crisis Beds:

• The House budget allocates $19,000,0000 to pay for renovation or building costs associated with constructing new behavioral beds, conversion of beds, or combination of both.
• The budget outlines specific dollar amounts of funding to specific medical centers for the use of this funding.

Traumatic Brain Injury Funding:

• The House budget designated the same amount of funding for this issue.
• $2.4 million for FY 2017-2018.
• $2.4 million for FY 2018-2019.
  • $359,218 would be used to fund contracts with Brain Injury Associations, Carolinas Rehabilitation or other providers.
  • $796,934 would be used for residential support for individuals with severe TBI.
  • $1.2 million would be used to support individuals with submitted requests.
• However, the House budget does not include the Adult and Pediatric Brian Injury Pilot funding in the Senate budget.

Health IT:
Health Information Technology:

• The House’s provision would direct DHHS and the State Chief Information Officer to improve coordination of information between hospitals, laboratories, and physician’s offices.

Health Information Exchange:

• The House’s budget would establish the same mandatory connectivity date to the HIE Network by June 1, 2019.
• However, the LME/MCOs would have an extended mandatory connectivity date of June 1, 2020.
• The funding for this provision is the same in both the House and Senate budgets:
  • $3,000,000 in nonrecurring funds would be used to support all activities related to upgrading the data exchange technical environment.
  • $1,000,000 in recurring funds would be used to provide ongoing maintenance.
• The House budget includes an additional study of the feasibility of Medicaid providers.

Controlled Substances Reporting System:

• The House budget outline $1,200,000 in recurring funds to DHHS for each fiscal year of the fiscal biennium for the CSRS. This is the same amount as the Senate budget.
  • Additionally, the House budget designates specific amounts for positions and contractual hours.

Graduate Medical Education:
Graduate Medical Education Funding/Cape Fear Valley Medical Center

• $3 million nonrecurring to support the establishment of residency programs affiliated with Campbell University School of Medicine.
• This non-recurring amount it equal to the total amount of lost Medicare payments issued to the Cape Fear Valley Medical Center prior to its reclassification by CMS as a rural hospital.

 Opioids:

• The House budget provides $100,000 to purchased opioid antagonists to serve individuals at risk of overdose. These kits would be distributed to at risk individuals and law enforcement agencies.

 The House budget does not contain any language from the Senate budget on balance billing, barring state funding to doctors, or program reimbursement as a basis for reprocurement of overpayments.
Medicaid Provider Fee:
Provider Application and Re-credentialing Fee

• This section states that providers that enroll in the Medicaid program shall submit a $100 application fee that would be charged every 5 years.

Medicaid Claims:
Repayment Claims Review Modifications

• If a provider fails to meet the 70 percent clean claims rate minimum, this may result in a termination action.
• This would result in the exclusion of the provider from future participation in the Medicaid program.

Upper Payment Limit:

• This provision would replace the existing definition of “eligible medical professional providers” to expand to professionals to include the following:
  • Medicaid enrolled NC physicians/medical professionals
  • UNC Health Care System
  • University Health Systems of Eastern North Carolina, Vidant Health
  • Public hospitals
  • Duke University faculty practice plan