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  • Summary date: Apr 4 2023 - View Summary

    Contains whereas clauses. Directs the Department of Health and Human Services, Division of Health Benefits (DHB) to increase the rate for services provided by direct support professionals (DSP) to Medicaid recipients under the North Carolina Innovations waiver, with the goal of increasing the hourly wages paid by providers to DSPs by $3.25 per hour for the 2023-24 and 2024-25 fiscal years. Requires providers receiving the rate increase to use at least 90% of the funding that results from the rate increase to pay higher wages to their DSP workforce. The wage increase should be in addition to the pay rate the DSP was receiving as of June 30, 2023. The rate increase is effective on the date the Centers for Medicare and Medicaid Services approve the increase, but no sooner than July 1, 2023. 

    Also requires DHB to adjust the per member per month capitation amounts paid to local management entities/managed care organizations (LME/MCO) to reflect the same rate increases. Requires that all providers employing DSPs verify to DHB or the relevant LME/MCO that at least 90% of the funding from the rate increase is being used to increase DSP pay. DHB is required to set standards for documentation to be required as verification and LME/MCOs must use the same standards. 

    Permits DHB to recoup part or all of the funds related to the rate increase if a provider does not use at least 90% of the funding to pay DSPs.

    Requires LME/MCOs to report on a quarterly basis during the 2023-25 biennium regarding provider development efforts and provider rate increases to the Joint Legislative Oversight Committee on Medicaid. 

    Appropriates $72 million to DHB from the General Fund in recurring funds for each year of the 2023-25 fiscal biennium for the rate increases. These funds area state match for federal funds of $140 million for each year of the 2023-25 biennium, and the federal funds are also appropriated to DHB for this purpose.