Senate amendment makes the following changes to the 4th edition.

Part I.

No longer repeals Sections 9D.15 (regarding the use of the Medicaid Transformation Fund for specified transformation needs) and 9D.15B (regarding Medicaid Transformation administrative reduction flexibility and reporting) of HB 966 (the Appropriations Act of 2019) if HB 966 becomes law.

No longer repeals all of Part II of the act if HB 966 becomes law. Instead, if HB 966 becomes law, repeals Section 2.1 and 2.2 (appropriating funds for Medicaid and NC Health Choice programs rebase, and for transitioning to Medicaid managed care, for the 2019-20 and 2020-21 fiscal years) and Part III of the act (providing for the use of the Medicaid Transformation Fund for specified Medicaid transformation needs).

Part III.

Changes the amount to be transferred from the Medicaid Transformation Reserve in the General Fund to the Medicaid Transformation Fund from $224 million to $193 million for the 2019-20 fiscal year, and from $45 million to $24 million for the 2020-21 fiscal year. 

Regarding the amount permitted to be transferred from the Medicaid Transformation Fund to the Department of Health and Human Services (DHHS), Division of Health Benefits, for the 2020-21 fiscal year for providing the State share for nonrecurring qualifying needs directly related to Medicaid transformation, specifies that the specified amount is in nonrecurring funds.

No longer authorizes transfers to the Division of Health Benefits for the 2019-20 and 2020-21 fiscal years for the purpose of providing nonrecurring funding for administrative expenses during the transition to Medicaid-managed care.

Part IV.

Deletes the provisions of Part IV, which reduced the budget of the Division of Health Benefits for the 2019-20 and 2020-21 fiscal years, and established reporting requirements regarding the Division's reduction of administrative costs.

Part IX.

Makes a technical change to new GS 143C-4-11. Further amends the statute to allow allocation or expenditure of funds from the Medicaid Contingency Reserve if the Director of the Budget finds additional funds are needed to cover a shortfall, after the State Controller has verified that all Medicaid and NC Health Choice program receipts are being used appropriately (previously, generally required prior verification of receipts).

Part X.

Amends Section 10.3(b) of the act, if HB 966 becomes law, regarding the transfer of receipts collected from supplemental and base assessments in excess of that anticipated in the Governor's proposed base budget for the 2019-20 fiscal year for the Division of Health Benefits. Now provides for the specified transfers if the receipts collected are in excess of those anticipated in HB 966, rather than the Governor's proposed base budget.

Part XII.

Amends new GS 143C-9-9 to refer to the Hospital Uncompensated Care Fund consistently throughout.