Medicaid PHP Licensure – HB 156

*June 14, 2018 – Proposed Committee Substitute to HB 156*

*June 22, 2018 Update*

This bill was signed by Governor Cooper on June 22, 2018.

The House voted 94-0 to adopt the Conference Report on June 15, 2018 and will now be sent to Governor Cooper.

The Senate voted to adopt the Conference Report on June 15, 2018.

The House placed this Conference Report on the calendar for June 15, 2018.

The Senate and House Reported on June 14, 2018.

The House and Senate appointed conferees to this bill on June 1, 2018.

The House failed to placed this bill on the calendar for May 30, 2018.

Conference Report Summary

Section 1

Definitions: 58-92-2

This portion defines a Commercial Plan, an enrollee, health care services, insolvency, a licensed health organization, a PHP, a PLE, and working capital.

Commissioner Consultants: 58-9-3

The portion would allow the Commissioner to contract with consultants to expedite the application process.

Licensing 58-93-5

This portion states that any commercial plan or PLE may apply for a license to operate as a PHP. This portion lists all of the minimum requirements for application.

Protection Against Insolvency 58-93-50

This portion would require a minimum capital surplus and maintain a plan for protection against insolvency. There would also be a requirement for the continuation of health services.

HB 156 – Medicaid PHP Licensure/Food Service State Buildings

Primary Sponsors: Rep. Allen McNeil (R-Moore), Rep. Donny Lambeth (R-Forsyth), Rep. Dobson (R-Avery), Rep. William Brisson (D-Bladen)

This bill would require Medicaid Prepaid Health Plans to obtain a license from the NC Department of Insurance. The bill lists minimum requirements for the application process. This bill also contains language on penalties, enforcement, management agreement, fees, fiduciary responsibilities, continuation of services, and suspension of licenses. Currently, the bill does not contain any of the Chapter 58 patient and provider protections.

NCMS is actively working to ensure that these protections are included moving forward.

In addition, this bill would make changes pertaining to the operation of food services at state facilities. The net proceeds of revenue generated by food or vending services shall be credited to the Division of Services for the Blind of the Department of Health and Human Services.

House:

This bill passed the House Health Committee on March 8, 2017.

This bill passed second and third readings in the House on March 8, 2017.

Senate:

This bill was referred to the Senate Rules and Operations Committee on March 9, 2017.

This bill was withdrawn from the Senate Rules and Operations Committee, and re-referred to the Senate Health Care Committee on May 16, 2017.

A proposed committee substitute was adopted in the Senate Health Care Committee on June 22, 2017.

This bill was re-referred to the Senate Rules and Operations Committee of the Senate on June 22, 2017.

This bill was withdrawn from the Senate Rules and Operations Committee, and re-referred to the Senate Finance Committee.

This bill passed the Senate Finance Committee on June 26, 2017.

This bill passed the Senate Rules and Operations Committee on June 27, 2017.

This bill will now move to the Senate floor.

This bill passed the Senate on June 28, 2017.

 

 

 

 

 
 

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