INMATE MEDICAID SUSPENSION/TEAM-BASED CARE.

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View NCGA Bill Details(link is external)2025-2026 Session
House Bill 546 (Public) Filed Wednesday, March 26, 2025
AN ACT TO REQUIRE TEAM-BASED CARE COORDINATION IN MEDICAID SUBSTANCE USE TREATMENT AND TO MODIFY THE MEDICAID PROGRAM TO SUSPEND RATHER THAN TERMINATE MEDICAID ELIGIBILITY FOR INCARCERATED INDIVIDUALS.
Intro. by White, Chesser, Reeder, Rhyne.

Status: Ref to the Com on Health, if favorable, Insurance, if favorable, Finance, if favorable, Rules, Calendar, and Operations of the House (House action) (Mar 31 2025)
H 546

Bill Summaries:

  • Summary date: Mar 26 2025 - View Summary

    Substantively identical to S 464, filed 3/24/25.

    Directs the Department of Health and Human Services, Division of Health Benefits (DHB) to establish a working group of stakeholders and develop a team-based care coordination Medicaid service that includes screening, recovery support, and case management for alcohol use disorder, opioid use disorder, and other mild to moderate substance use disorders. Requires DHB to report to the Joint Legislative Oversight Committee on Medicaid and the Fiscal Research Division no later than October 1, 2025, regarding the Medicaid service, including the state’s share of the cost, start date of the service, and the types of contracts and any statutory changes proposed to implement the service. Also directs DHB to develop a statewide campaign to educate healthcare providers and community leaders about changes to the Medicare program and train interested healthcare providers in clinical care for the substance use disorders.

    Requires DHB to update Medicaid policy to implement the federal directive to suspend rather than terminate Medicaid coverage upon a Medicaid recipient's incarceration. Directs DHB and the Department of Adult Correction to enter into a memorandum of understanding to share information regarding the Medicaid eligibility status of individuals entering confinement or being released from jails. Also directs the Department of Adult Correction to update its internal and external policies and manuals to reflect the updated policy and its implementation.