AN ACT TO MODERNIZE AND STABILIZE NORTH CAROLINA'S MEDICAID PROGRAM THROUGH FULL‑RISK CAPITATED HEALTH PLANS TO BE MANAGED BY A NEW DEPARTMENT OF MEDICAL BENEFITS.
Senate committee substitute makes the following changes to the 4th edition.
Amends Section 2 of this act to add to the principal building blocks of the Medicaid reform as directed by Section 1 (Intent and Goals) of this act. Provides that the capitated health plans (a health care system in which the provider is given a set fee per patient regardless of the treatment required) authorized by this act may work in collaboration with the Local Management Entity/Managed Care Organizations (LME/MCOs) created to serve the Medicaid population (in SL 2011-264).
Amends Section 3 of this act regarding the timeline for the milestones for Medicaid reform under this act. Provides that the new legislative oversight committee to oversee the Medicaid and NC Health Choice programs is to be created when this act becomes law (was, no later than August 1, 2014). Declares that the new Department of Medical Benefits (DMB) is to be created no later than September 1, 2014 (was, August 1, 2014). Moves the dates forward for additional milestones on the timeline as follows: (1) requires the DMB to submit its initial report on reform plan details by April 15, 2015 (was, March 1, 2015), and (2) requires final approvals from the Centers for Medicare & Medicaid Services (CMS) for the reform plan by February 1, 2016 (was, January 1, 2016). Makes conforming changes to amend additional occurrences of these changes in milestone dates. Provides that if the detailed plan cannot be reasonably completed by the April 15 deadline, the DMB is to inform the General Assembly by March 15 that the April 15 report will be a progress report and provide an update on the progress made on completing a plan and report on the parts of the plan that have been completed by April 15.
Corrects a statutory citation in Section 9, deleting a reference to GS 143B-1410(a)(8) and replacing it with GS 143B-1410(a)(10) as enacted by Section 10 of this act.
Amends GS 143B-1415 to correct a statutory reference,deleting a reference to GS 143B-1410(a)(8) and replacing it with GS 143B-1410(a)(10) as enacted by Section 10 of this act.
Amends new GS 143B-1405(d) to further clarify which individuals may not serve on the Board of the DMB. Makes technical changes to renumber the subdivision provisions in subsection (d) accordingly. Inserts the words "North Carolina" before each occurrence of the word "Medicaid" in this subsection. Amends subsection (d) of this section to define the term providerto have the same meaning as in GS 108C-2.
Amends new GS 143B-1410(a)(10) to require the Board of the DMB to develop and present information as specified in this subdivision for the Medicaid and NC Health Choice programs to the General Assembly and the Office of State Budget and Management by January 1 of each year, beginning in 2016 (was, present the information to the General Assembly).
Provides that Sections 10 (creating the DMB) and 11 (regarding initial board compensation) become effective September 1, 2014 (was, Sections 10, 11, and 12 become effective August 1, 2014).
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