View NCGA Bill Details2021
Senate Bill 615 (Public) Filed Tuesday, April 6, 2021
Intro. by Murdock, Nickel, Mayfield.

Status: Ref To Com On Rules and Operations of the Senate (Senate action) (Apr 7 2021)

Bill History:

S 615

Bill Summaries:

  • Summary date: Apr 7 2021 - More information

    Requires the Department of Health and Human Services, Division of Health Benefits (DHB), to provide a 15% rate increase option for personal care services reimbursed under three specified Medicaid Clinical Coverage Policies that cover State Plan Personal Care Services, the Community Alternatives Program for Children, and the Community Alternatives Program for Disabled Adults. Requires, to be eligible for the 15% rate increase option, that a provider attest and verify it will be used to increase the wages of all direct care professionals it employs no less than fifteen dollars $15/hour and agree to, at a minimum, provide any data required to be collected under this act. 

    Requires DHB, upon implementing the rate increase option, to adjust the per member per month (PMPM) capitation amount paid to local management entity/managed care organizations (LME/MCOs) that operate capitated contracts for mental health, intellectual and developmental disabilities, and substance abuse services and to prepaid health plans (PHPs). Requires LME/MCOs and PHPs to require a provider electing this option to attest and provide verification that the rate increase will be used to increase the wages of all direct care professionals it employs to at least $15/hour and agree to, at a minimum, provide any data required to be collected under this act.


    Makes the rate increase option and the capitation rate adjustments effective only upon both of the following: (1) termination of the rate increases totaling 15% total for providers of personal care services implemented as a result of the nationwide public health emergency as a result of the 2019 novel coronavirus; and (2) Centers for Medicare and Medicaid Services (CMS) approval of the increase.

    Appropriates $9.3 million in recurring funds for 2021-22 and $21,850,000 in recurring funds for 2022-23 from the General Fund to DHB to implement the rate increase. Specifies that these funds are to provide the State match of the specified amounts of federal funds; appropriates those federal funds to DHB. Effective July 1, 2021.

    Requires each provider receiving the rate increase option to track and report to DHB, using a tool developed by DHB, how that provider used the rate increase to increase the wages of all direct care professionals, beginning within 60 days of receiving the increase and annually thereafter. Specifies information that must be provided to DHB. Specifies provider record keeping requirements and allows DHB to to conduct audits at the provider's expense.

    Sets out requirements for the notice that providers must give to the direct care professionals they employ on the wage increase. 

    Requires DHB to create a mechanism by which direct care professionals may report an employer who has failed to pay the required wages and requires DHB to investigate such reports.

    Allows DHB to recoup funds when a provider fails to comply with the wage or reporting requirements.

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