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  • Summary date: Apr 11 2019 - View Summary

    Identical to S 537, filed 4/2/19.

    Includes whereas clauses.

    Directs the Department of Health and Human Services (DHHS) to establish and convene a workgroup to evaluate reimbursement options under managed care for adult care homes that takes into account all funding streams and to develop a service definition or definitions under managed care to accomplish the General Assembly's intent to provide stable and reliable funding to adult care homes in order to ensure access, choice and quality of care.  Requires the participation of representatives of the adult care home industry and other relevant stakeholders in the workgroup.  Mandates the inclusion of the following components in the development of the service definition: (1) supoprt for alternative payment models, including pay-for-performance initiatives, available under the State's 1115 Medicaid waiver and Medicaid transformation; (2) best practices for long-term services and supports; and (3) efficient payment methodologies. 

    Requires DHHS to submit a report no later than October 1, 2020, to the Joint Legislative Oversight Committees on Health and Human Services, and Medicaid and NC Health Choice, as well as the Fiscal Research Division regarding the new service definition.  Directs DHHS after this submission to submit to the Centers for Medicare and Medicaid Services any amendments to the NC Medicaid State Plan necessary to implement the new definition.