MEDICAID BILLING BY LOCAL HEALTH DEPARTMENTS.

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View NCGA Bill Details2011-2012 Session
Senate Bill 245 (Public) Filed Monday, March 7, 2011
TO AUTHORIZE LOCAL PUBLIC HEALTH DEPARTMENTS TO BILL MEDICAID THROUGH AN APPROVED MEDICAID CLEARINGHOUSE OR THROUGH THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, DIVISION OF PUBLIC HEALTH.
Intro. by Hartsell.

Status: Ch. SL 2011-90 (Senate Action) (May 26 2011)
S 245/S.L. 2011-90

Bill Summaries:

  • Summary date: Jun 1 2011 - View Summary

    AN ACT TO AUTHORIZE LOCAL PUBLIC HEALTH DEPARTMENTS, DISTRICT HEALTH DEPARTMENTS, AND CONSOLIDATED HUMAN SERVICES AGENCIES TO BILL MEDICAID THROUGH AN APPROVED MEDICAID CLEARINGHOUSE OR THROUGH THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, DIVISION OF PUBLIC HEALTH. Summarized in Daily Bulletin 3/7/11, 3/17/11, 5/17/11 and 5/18/11. Enacted May 26, 2011. Effective May 26, 2011.


  • Summary date: May 18 2011 - View Summary

    House amendment makes the following change to 3rd edition. Provides that local health departments, district health departments, and consolidated human services agencies may rebill outside the HIS system any unpaid Medicaid claims submitted between July 1, 2010 (previously December 1, 2010) and the effective date of the act (when the act becomes law).


  • Summary date: May 17 2011 - View Summary

    House committee substitute makes the following changes to 2nd edition. Amends proposed GS 130A-34.2(b) to clarify that the required data must be provided in a format specified by the Division of Public Health (Division). Amends proposed GS 130A-34.2(c) to direct local health departments, district health departments, and consolidated human services agencies to make encounter-level data available for the Division, in a format specified by the Division, in order to comply with federal grant reporting requirements (previously, the entities were not required to submit encounter-level data). Specifies that local health departments are not required to use Common Name Data System for any purpose. Amends proposed GS 130A-34.2(e) to clarify that local health departments, district health departments, and consolidated human services agencies retain the responsibility to supply the Division of Medical Assistance and/or the Centers for Medicare and Medicaid Services with documentation to support audit processes and procedures to confirm and validate cost study reimbursement data. Clarifies the definition of aggregate data. Authorizes local health departments, district health departments and consolidated human services agencies to rebill outside of the Health Information System any unpaid Medicaid claims submitted between December 1, 2010, and the effective date (the date the act becomes law).


  • Summary date: Mar 17 2011 - View Summary

    Senate committee substitute makes the following changes to 1st edition. Deletes proposed GS 130A-45.14 and instead enacts new GS 130A-34.2, which contains the provisions of proposed GS 130A-45.14 but expands the coverage of the statute to include district health departments and consolidated human services agencies in addition to local health departments. Removes proposed definitions from GS 130A-45.01 and places them under proposed new GS 130A-34.2. Changes the act’s effective date from October 1, 2011, to when the act becomes law and provides that the act applies to Medicaid claims arising on or after the act’s effective date. Changes the title of the act to AN ACT TO AUTHORIZE LOCAL PUBLIC HEALTH DEPARTMENTS, DISTRICT HEALTH DEPARTMENTS, AND CONSOLIDATED HUMAN SERVICE AGENCIES TO BILL MEDICAID THROUGH AN APPROVED MEDICAID CLEARINGHOUSE OR THROUGH THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, DIVISION OF PUBLIC HEALTH.


  • Summary date: Mar 7 2011 - View Summary

    Amends GS 130A-45.01 to add definitions for the following terms as used in proposed GS 130A-45.14, local health department billing of Medicaid, (1) aggregate data, (2) encounter level data, and (3) public health program services. Defines Health Information System (HIS) to mean the system operated by the North Carolina Division of Public Health and used by local health departments to record information about services the local health departments provide.
    Enacts new GS 130A-45.14 to permit local health departments to bill public health program services to Medicaid by submitting claim data (1) to HIS and manage 837/835 billing files within HIS; or (2) to any approved Medicaid clearinghouse and manage 837/835 billing files within that system. Provides additional criteria regarding requirements for local health departments and reimbursement rates. Effective October 1, 2011.