SB 808 – Medicaid Funding Act

SB 808 – Medicaid Funding Act

Primary Sponsors: Sen. Harry Brown (R-Onslow), Sen. Kathy Harrington (R-Gaston), Sen. Brent Jackson (R-Sampson)

*This bill was introduced as a PCS in the House Appropriations Committee on June 22, 2020 to revise and update the hospital assessments.

*This bill was introduced as a PCS in the House Rules Committee on June 24, 2020 to make compromise changes in order to move the bill.

 

Summary

Dorothea Dix Relocation Project

  • $15 million in nonrecurring funding for the relocation of DHHS in Wake County

Child Welfare Case Management – NC FAST

  • $26.4 million in nonrecurring funding for updates and changes to the child welfare case management component of NC FAST.

Behavioral Health and Crisis Service (COVID-19)

  • $50 million in nonrecurring funding to the LME/MCOs

Early Childhood Initiatives

  • $20 million in nonrecurring funds for early childhood initiatives to assist in mitigating the financial impact due to the COVID-19 pandemic

Additional Coronavirus Relief Funds for Testing, Tracing, Tracking, and Analysis

  • $100 million in funding to expand testing for surveillance including hiring more temporary staff for tracing

Medicaid Budget Surplus

  • This section disallows DHHS to transfer a Medicaid budget surplus to LME/MCOs

Medicaid Funding

  • $1.4 million in nonrecurring funds to be used for the implementation of an electronic visit verification system for personal care services and home health services under the Medicaid program.
  • $30,000 in nonrecurring funds shall not revert at the end of the fiscal year but shall remain available and used for Medicaid/NC Health Choice programs rebase in 2020-21
  • $84 million in nonrecurring funds for Medicaid and NC Health Choice programs rebase
  • $136 million in nonrecurring funds to the Medicaid Contingency Reserve
  • $213 million from the General Fund to the Medicaid and NC Health Choice programs rebase

Medicaid Transformation

  • Sets a new Medicaid Transformation go live date of July 1, 2021
  • $69.4 million transferred to the Medicaid Transformation Fund
  • Requires DHHS to maintain a hotline for customer service questions related to transformation
  • Allows for a tribal option for Medicaid Transformation
  • Creates a Medicaid Contingency Reserve to be used for budget shortfalls
  • Includes gross premiums tax for the prepaid health plans

New Payment Models

  • Revises the hospital assessment
  • Revises supplemental payments
  • Repeals past requirement eliminate GME to align with Medicaid Transformation
  • Creates hospital uncompensated care fund

 

 

 

This is the summary of the bill language before it was amended in committee on June 10, 2020.

Delay Implementation

  • This bill would require Medicaid Transformation implementation by January 1, 2021.

Funds

  • This bill would appropriate funds to the operation of the NC Medicaid program. No set amounts are listed in this bill as of 5/19/2020. (*This is consistent with the other Senate appropriation bills.)

Use of Medicaid Transformation Fund 

  • The bill appropriates a non-recurring amount for Medicaid Transformation needs in the 2020-21 fiscal year. No set amounts are listed in this bill as of 5/19/2020.
  • The bill appropriates a non-recurring amount to the Division of Health Benefits as needed for the purpose of paying claims to services billed under fee for service. No set amounts are listed in this bill as of 5/19/2020.
  • The bill appropriates nonrecurring funds as needed, and not a lump sum to the Division of Health Benefits for qualifying needs relating to transformation including program design, beneficiary experience, NC FAST upgrades, data management, program integrity, and technical operations.
  • The bill requires the Office of State Budget and Management to oversee the funding use and ensure any requested amount does not exceed $140 million.

GME

  • The bill repeals the past directive to eliminate GME to align with Medicaid Transformation.

Medicaid Transformation Hotline

  • The bill requires DHHS to ensure that the existing DHHS customer service hotline is responsive to questions posed by a Medicaid beneficiary, provider, or the general public.

Tribal Option

  • The bill creates a new option for DHHS to contract with an Indian managed care entity or Indian Health care provider to assist in services to federally recognized tribes.

Revise Supplemental Payments

  • The bill states that the program shall no longer utilize a limit on the number of eligible medical providers that may be reimbursed the program and instead shall limit the total payments made under the program.
  • The bill requires payments to increase reimbursement to the average commercial rate under the State Health Plan and direct that payments increase to the average commercial rate under the managed care system.
  • The bill creates a roll out period for creating this new system.

Medicaid Contingency Reserve

  • The bill creates a Medicaid reserve to be used for budget shortfalls.

Revise Hospital Assessments

  • The bill gives authority to NC DHHS to adjust the hospital assessment payment amounts between October 2020 and December 2020.
  • The bill exempts certain types of hospitals from the supplemental assessment and base assessment.

Gross Premiums/Prepaid Health Plans

  • The bill states that the tax in this section shall be measured by the gross capitation payments received by the prepaid health plan from DHHS for services provided to enrollees in the Medicaid program.
  • The bill states that capitation payments refunded by a prepaid health plan to the State are the only allowable deductions.
  • The set tax rate to be applied to gross premiums is 1.9%.

Hospital Uncompensated Care Fund

  • The bill creates a special fund consisting of federal adjustment receipts arising from certified public expenditures.
  • The funding could be used for payments to institutions for mental diseases and payments to hospitals to reimburse inpatient services, uncompensated care costs, or outpatient services.

History

Filed – 5/19/2020

This bill was passed as a proposed committee substitute in the Senate Appropriations Committee on June 10, 2020.

This bill passed in the Senate Rules Committee on June 15, 2020.

This bill passed the Senate 43-5 on June 17, 2020.

A proposed committee substitute was heard in the House Appropriations on June 22, 2020.

This bill passed on June 23, 2020.

A proposed committee substitute was heard on the House Rules Committee on June 24, 2020.

A clarifying amendment was passed on the House floor on June 25, 2020.

This bill passed the House with a vote of 111-2 on June 25, 2020.

This bill will now be sent to the Senate.

 

 

 
 

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