Bill Summary for S 656 (2023-2024)

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Summary date: 

Apr 10 2023

Bill Information:

View NCGA Bill Details2023-2024 Session
Senate Bill 656 (Public) Filed Thursday, April 6, 2023
Intro. by Grafstein.

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Bill summary

Requires the Department of Health and Human Services, Division of Health Benefits (DHB), to submit by July 1, 2023, to the Centers for Medicare and Medicaid Services (CMS) any amendment to the 1115 waiver for Medicaid Transformation necessary for approval to effectuate the following changes related to BH IDD Tailored Plans: (1) beneficiaries may opt to remain in the Medicaid fee-for-service program (Medicaid Direct) for physical healthcare services when any of the beneficiary's healthcare providers are not contracted with the LME/MCO Tailored Plan network, if staying in Medicaid Direct is necessary as a reasonable accommodation of the beneficiary's need for continuity of care and (2) based on differing service arrays, available services, or provider networks, beneficiaries may opt into a BH IDD tailored plan operating outside of the region where they reside.

Requires DHB to report by August 1, 2023, to the specified NCGA committee with recommendations for promoting competition among local management entities/managed care organizations in a way that fosters innovation and leads to better care for Medicaid beneficiaries. Also requires inclusion of a copy of all State Plan amendments or other documents submitted to CMS in accordance with the above provision, and legislative changes needed.