Senate Budget Summary

2019 Senate Budget Overview

Central Management and Support

Rural Loan Repayment

  • This provision provides funding for loan repayment incentives to recruit doctors, dentists, nurse practitioners, and certified nurse midwifes to rural areas.
  • This budget appropriates $3.5 million non recurring (NR) in fiscal year (FY) 2019-20 and $1 million (NR) in FY 2020-21

Telemedicine Pilot Program

  • This provision provides $500,ooo NR funds in FY 2019-20 for Southeastern Regional Medical Cener to administer a telemedicine pilot program.

Health Informaiton Exchange (HIE) Network – NC HealthConnex

  • This provision pushed back the HIE connection date for psychiatrists to June 1, 2021.
  • This provision also includes language to allow DHHS to establish a process to allow other providers and entities to apply for limited time extensions.
  • The provision also lists 10 other entities that may submit data voluntarily.

Health Benefis

Medicaid Eligibility

  • This provision would provide Medicaid coverage for families, children under the age of 21, pregnant women, individuals who are aged, blind or disabled, or medically needy subject to the following annual income levels after meeting the applicable deductible.
    • Family Size – 1- $2,904
    • Family Size -2-$3,804
    • (for entire list view the budget document here)
  • This provision also makes changed to families and children under the age of 21.
  • This provision also includes the following populations:
    • Children under the age of 6 with families with incomes less than 210% of the federal poverty line.
    • Children ages 6-18 with families with incomes less than 133% of the federal poverty line.
    • Children under 19 who are receiving foster care services.
    • Former foster care children under the age of 26.
    • Pregnant women with incomes less than 196% of the federal poverty line.
    • Men and women of childbearing age with family incomes less than 195% for family planning services.
    • Women who need treatment for breast or cervical cancer.
    • Age, blind, disabled individuals with incomes less than 100% of the federal poverty guidelines.
    • Beneficiaries receiving supplemental social security income.
    • Workers with disabilities.
    • Qualified working disabled individuals.
    • Qualified Medicare beneficiaries with incomes less than 100% of the federal poverty line.
    • Recipients of an optional state supplementation program.
    • Refugees
    • Undocumented aliens, only for emergency services.

Innovations Waiver Slots

  • This provision provides funding for an additional 1,000 individuals with intellectual and developmental disabilities.
  • $33,000,000 recurring in FY 2019-20 and $66,000,000 recurring in FY 2020-21

Increase in Medicaid Co-Payments

  • This provision increases copayment for Medicaid beneficiaries to $4.

Increase in Reimbursement for Primary Care Providers

  • This provision directs DHHS to increase the reimbursement for the evaluation and management codes that are paid to primary care physicians, OBGYNS, nurse practitioners and physician assistants and are contained in the State Plan amendment submitted by DHHS.

Medicaid Transformation

Tribal Option

  • This provision states that DHHS may contract with an Indian managed care entity or Indian health care provider to assist in services to Medicaid and NC Health Choice beneficiaries.

Hospital Assesments, Supplemental Payments, and Directed Payments

  • This provision allows proceeds of assessments to be used to make the State’s annual Medicaid payment to the State, to fund payments made directly by DHHS, to fund payments to hospitals by the Department, to fund a portion of capitation payments to prepaid health plans attributable to hospital care, and to fund the no federal share of graduate medical education payments.


  • This provision requires all Prepaid Health Plans to be measured by the gross capitation payments for services provided to enrollees. The tax rate to be applied would be 1.9%.

ECU Brody School of Medicine

  • This provision would amend the Medicaid State Health Plan to no longer reimburse the primary affiliated teaching hospital for ECU for allowable costs for inpatient and outpatient services. Services would be reimbursed in the same manner as other private hospitals under the Medicaid State Plan.

Health Service Regulation

Certificate of Need

  • This provision amends certificate of need laws by doing the following:
    • Removing “bed capacity” to refer to the number of kidney dialysis stations
    • Removing psychiatric facilities, chemical dependency centers, and diagnostic centers
    • Removing psychiatric beds, immediate care beds for the mentally ill, and chemical dependency treatment beds
    • Removing ambulatory surgical centers
    • Removing gastrointestinal endoscopy rooms
  • This provision states that a recipient of a certificate of need shall complete the project authorized within two years.
  • This provision states that the Department shall withdraw a CON issued to any recipient that ceases operation.
  • This provision also allows an affected person in a contested case regarding CON, to allow the Court of Appeals, in an action for judicial review to award all costs of such action to the prevailing party.

Mental Health

Traumatic Brain Injury Funding

  • This bill appropriates $2,373,086 in recurring funding for FY 2019-20 and in FY 2020-21 to support TBI services.

Public Health

Youth Tobacco

  • This provision appropriates $300,000 in recurring funds for the Alcohol Law Enforcement Branch for the statewide compliance checks to enforce the youth tobacco laws.

Medication Assisted Opioid Use Disorder Treatment Pilot

  • This provision would appropriate $500,000 for each year to the continuation of the medicaication assisted opioid use disorder pilot program.




The special provisions 0f the 2019 Senate budget can be found here.


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