MEDICAID TRANSFORMATION.

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View NCGA Bill Details2015-2016 Session
Senate Bill 703 (Public) Filed Thursday, March 26, 2015
AN ACT TO TRANSFORM THE MEDICAID PROGRAM FROM A MOSTLY FEE-FOR-SERVICE PROGRAM TO A CAPITATED, RISK-BASED, MANAGED CARE PROGRAM.
Intro. by Berger.

Status: Ref To Com On Rules and Operations of the Senate (Senate Action) (Mar 30 2015)

Bill History:

S 703

Bill Summaries:

  • Summary date: Apr 1 2015 - View Summary

    Requires the Department of Health and Human Services, Division of Medical Assistance (Department), to implement a plan to transform North Carolina's Medicaid program to a program that, no later than January 1, 2017, accomplishes the following: (1) transforms the current mostly fee‑for‑service Medicaid program into a capitated, risk‑based, managed care Medicaid program; (2) enters into risk contracts with at least three statewide Medicaid managed care organizations that assume full risk for all Medicaid benefits; (3) enrolls all Medicaid beneficiaries, to the maximum extent allowable under federal law or waiver, in a statewide Medicaid managed care organization; and (4) makes changes to the NC Health Choice program that correspond with the changes made to the Medicaid program. Requires the Department to  report to the Joint Legislative Oversight Committee on Health and Human Services and the Fiscal Research Division by October 1, 2015, on the plan and specifies items that must be included in the report. Requires the Department, by June 1, 2016, to publish a request for proposal for the risk contracts. Requires the Department to submit to the Centers for Medicare and Medicaid Services (CMS) the state plan amendments necessary to accomplish the requirements of this act within the required time frames. States the General Assembly's intent to appropriate the funds necessary to accomplish the Medicaid transformation.