Includes several whereas clauses.
Repeals Section 3 of SL 2013-5, which states that the State will not expand the State's Medicaid eligibility under the Affordable Care Act and prohibits State entities from attempting to expand the Medicaid eligibility standards provided in SL 2011-145 (Appropriations Act of 2011), as amended, or other state law, unless upon legislative directive.
Enacts GS 108A-54.3B to define a class of eligible beneficiaries for the Medicaid program to receive benefits through an Alternative Benefit Plan established by the Department of Health and Human Services (DHHS) consistent with federal requirements, unless the beneficiary is exempt from mandatory enrollment in the Alternative Benefit Plan under specified federal law. Defines the class of eligible individuals considered part of the Medicaid coverage gap and eligible for Medicaid benefits by four requirements: (1) the individual has a modified adjusted gross income that is at or below 133 percent of the federal poverty level; (2) the individual is at least 19 and younger than 65 years old; (3) the individual is not entitled to or enrolled in Medicare benefits under Parts A or B of Title XVIII of the Social Security Act; and (4) the individual is not otherwise eligible for Medicaid coverage under the State Plan as it existed on January 1, 2020. Provides that co-payments for benefits under the Alternative Benefit Plan for the described eligible beneficiaries must be the same as co-payments for other Medicaid beneficiaries not under the Alternative Benefit Plan.
Directs DHHS to provide coverage for the described eligible individuals pursuant to new GS 108A-54.3B consistent with SL 2015-245 (Medicaid Transformation and Reorganization), as amended.
Effective on the date that capitated coverage required under SL 2015-245, as amended, begins. Requires the DHHS Secretary to report to the Revisor of Statutes when the provision of capitated coverage has commenced.
States the legislative intent to enact legislation during the 2019 Regular Session to replace the Hospital Provider Assessment Act, Article 7, GS Chapter 108A, with a similar hospital provider assessment that includes imposition of a Medicaid Coverage Gap Assessment that will pay for the State share of the program and administrative costs associated with Medicaid expansion.
Appropriates from the General Fund to the Division of Health Benefits (DHB), DHHS, $250,000 in nonrecurring funds for the 2019-20 fiscal year for purposes of planning and preparation related to implementation of the Medicaid coverage provided in the act. Provides that unexpended or unencumbered funds do not revert at the end of the fiscal year.
Bill H 1040 (2019-2020)Summary date: Apr 28 2020 - View summary