Bill Summaries: S595 PRIMARY CARE PAYMENT REFORM TASK FORCE.

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  • Summary date: Apr 5 2023 - View Summary

    Establishes the NC Primary Care Payment Reform Task Force (Task Force) to perform the following duties: (1) establish a definition of primary care to be utilized by the Task Force that is applicable to services and care provided under the NC Medicaid program, the State Health Plan, and commercial insurance; (2) conduct an actuarial evaluation of the current healthcare spend on primary care services, both as it relates to the NC Medicaid program and the  commercial market, including Medicare Advantage plans; (3) determine the adequacy of the primary care delivery system in North Carolina, including the impact this system has on the supply of the primary care providers in this State; (4) study the primary care payment landscape in other states, specifically considering states that have implemented a minimum primary care spend; (5) identify data collection and measurement systems to inform creation of a primary care investment target for the NC Medicaid program, the State Health Plan, and commercial insurance, including a method by which to measure improvements made toward that target; (6) evaluate the need for a permanent Task Force, or other similar entity, including which State agency or body is best suited to oversee the work of that group; (7) perform any other studies, evaluations, or determinations the Task Force considers necessary. Sets forth membership composition of the eight members of the Task Force, including selecting bodies. Specifies all members are voting members. Specifies that any vacancies that occur for any membership positions that are not held as a function of office will be filled by the selecting body upon vacancy. Requires the Deputy Secretary for NC Medicaid, or the Deputy Secretary's designee, to serve as the chair of the Task Force.

    By no later than April 1, 2024, requires the Task Force to submit a report with its findings and recommendations to the specified NCGA committees. Requires the findings and recommendations to include specific, concrete, and actionable steps to be undertaken by the State and upon which the General Assembly could act.

    Expires May 1, 2024.

    Effective July 1, 2023, appropriates from the General Fund to the Department of Health and Human Services, Division of Health Benefits $250,000 in nonrecurring funds for the 2023-2024 fiscal year to be used for any actuarial evaluation undertaken by the Task Force.