Bill Summaries: S402 (2021)

  • Summary date: Mar 30 2021 - View summary

    Repeals Section 3 of SL 2013-5, which prohibits any State entity from expanding Medicaid eligibility as provided in PL 111-148 (the Affordable Care Act) and SL 2011-145.

    Enacts GS 108A-54.3B, providing criteria under which individuals are considered part of the Medicaid coverage gap and are eligible for Medicaid benefits through an Alternative Benefit Plan established by the Department of Health and Human Services (DHHS), unless the individual is exempt from mandatory enrollment in an Alternative Benefit Plan under 42 CFR 440.315. Eligibility is based on income, age, and ineligibility for enrollment in described Medicaid coverage. Mandates that copayments for benefits provided under the Alternative Benefit Plan must be the same as those required for Medicaid beneficiaries not under the Alternative Benefit Plan.

    Directs DHHS to provide coverage to individuals eligible under new GS 108A-54.3B, consistent with SL 2015-245, as amended (Medicaid Transformation and Reorganization).

    Requires funding for costs for providing coverage pursuant to the act from federal funds received due to the temporary increase in the federal medical assistance percentage (EMAP) under specified federal law. Specifies the intent of the NCGA to impose a Medicaid Coverage Gap Assessment upon hospital providers subject to Article 7A of GS Chapter 108A to pay for the State share of the program and associated administrative costs when costs associated with the increase in FMAP are no longer sufficient.

    Effective July 1, 2021.