Requires the Department of Health and Human Services, Division of Health Benefits (DHB), in consultation with stakeholders, to submit a request meeting the following goals to the Centers for Medicare and Medical Services (CMS) that: (1) provides Medicaid coverage of personal care services to residents in licensed adult care homes and special care units whose income exceeds the State-County Special Assistance Program limits, but does not exceed either 180% of the federal poverty level (for those who would otherwise qualify for State-County Special Assistance at the basic rate) or 200% of the federal poverty level (for those who would otherwise qualify for State-County Special Assistance at the enhanced rate); (2) ensures cost of any new Medicaid coverage requested is offset by savings or cost avoidance; and (3) ensures compliance with applicable legal requirements. Requires DHB to take any necessary actions to implement this act and submit the request to CMS within 90 days of the act becoming law.
DHB can only implement Medicaid coverage described in the request if it is approved by CMS and it meets all of the goals described above.
ADULT CARE HOME MEDICAID PCS COVERAGE.
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| View NCGA Bill Details | 2025-2026 Session |
AN ACT TO REQUIRE A REQUEST FOR FEDERAL APPROVAL TO EXTEND MEDICAID ELIGIBILITY FOR PERSONAL CARE SERVICES TO CERTAIN INDIVIDUALS RESIDING IN ADULT CARE HOMES.Intro. by Sauls, Potts.
Status: Re-ref to Health Care. If fav, re-ref to Finance. If fav, re-ref to Rules and Operations of the Senate (Senate action) (May 27 2025)
Bill History:
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Mon, 24 Mar 2025 House: Filed
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Tue, 25 Mar 2025 House: Passed 1st Reading
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Tue, 8 Apr 2025 House: Reptd Fav
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Tue, 8 Apr 2025 House: Re-ref Com On Judiciary 1
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Tue, 15 Apr 2025 House: Reptd Fav
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Tue, 15 Apr 2025 House: Re-ref Com On Rules, Calendar, and Operations of the House
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Tue, 15 Apr 2025 House: Reptd Fav
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Tue, 15 Apr 2025 House: Cal Pursuant Rule 36(b)
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Tue, 15 Apr 2025 House: Placed On Cal For 04/16/2025
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Wed, 16 Apr 2025 House: Passed 2nd Reading
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Wed, 16 Apr 2025 House: Passed 3rd Reading
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Thu, 17 Apr 2025 House: Regular Message Sent To Senate
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Mon, 28 Apr 2025 Senate: Regular Message Received From House
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Mon, 28 Apr 2025 Senate: Passed 1st Reading
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Mon, 28 Apr 2025 Senate: Ref To Com On Rules and Operations of the Senate
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Tue, 27 May 2025 Senate: Withdrawn From Com
H 485
Bill Summaries:
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Bill H 485 (2025-2026)Summary date: Mar 24 2025 - View Summary
View: All Summaries for Bill

Substantively identical to S 699, filed 3/25/25.