MEDICAID EXPANSION/HEALTHCARE JOBS INITIATIVE.

View NCGA Bill Details2017-2018 Session
House Bill 858 (Public) Filed Wednesday, April 19, 2017
AN ACT TO EXPAND ELIGIBILITY FOR THE MEDICAID PROGRAM TO INCLUDE ALL PEOPLE UNDER AGE SIXTY-FIVE WHO HAVE INCOMES EQUAL TO OR BELOW ONE HUNDRED THIRTY-THREE PERCENT OF THE FEDERAL POVERTY LEVEL, TO APPROPRIATE FUNDS FOR COSTS ASSOCIATED WITH THE EXPANSION, TO ACCOUNT FOR THE SAVINGS TO OTHER STATE PROGRAMS AS A RESULT OF THE EXPANSION, AND TO HAVE THE STATE SHARE OF COSTS OF THE EXPANSION FUNDED BY HOSPITAL PROVIDERS.
Intro. by Farmer-Butterfield, Earle, Autry, B. Richardson.

Status: Ref To Com On Appropriations (House Action) (Apr 20 2017)

Bill History:

H 858

Bill Summaries:

  • Summary date: Apr 19 2017 - More information

    Identical to S 290, filed 3/15/17.

    Includes whereas clauses.

    Repeals Section 3 of SL 2013-5, which prohibited the expansion of the State's Medicaid eligibility.

    Requires the Department of Health and Human Services (DHHS), Division of Medical Assistance (Division), to, beginning January 1, 2018, provide Medicaid coverage to all people under age 65 who have incomes equal to or less than 133% of the federal poverty guidelines. Specifies that the medical assistance provided to persons in this Affordable Care Act expansion group is to consist of the coverage described in 42 USC § 1396a(k)(1).

    States the General Assembly's intent to utilize the Medicaid Expansion Assessment under new GS 108A‑131, as well as savings to other state programs as reflected in this act to pay for the State share of costs associated with Medicaid expansion.

    Appropriates $27,481,199 in recurring funds for the 2017‑18 fiscal year and $41,023,521 in recurring funds for 2018‑19 from the General Fund to the Division to pay for administrative costs associated with Medicaid expansion. Specifies that these funds provide a state match for the specified amount in federal funds and provides that those federal funds are appropriated to pay for administrative costs associated with Medicaid expansion. Provides that if the amount of federal funds available to pay for administrative costs associated with Medicaid expansion exceeds the amounts set out in the act, then the expenditure of State funds must be reduced by an amount equal to the amount of available excess federal funds, and appropriates those excess federal funds for the described purposes.

    Appropriates $114,848,013 in recurring funds for 2017‑18 from the Division to pay for service costs associated with Medicaid expansion. Appropriates $6,731,823 in recurring funds for 2017‑18 from the General Fund to the Division to pay for service costs associated with Medicaid expansion. Specifies that these funds provide a state match for the specified amount in federal funds and provides that those federal funds are appropriated to pay for service costs associated with Medicaid expansion. 

    Appropriates $273,397,475 in recurring funds for 2018‑19 from the Division to pay for service costs associated with Medicaid expansion. Appropriates $21,347,825 in recurring funds for 2018‑19 from the General Fund to the Division to pay for service costs associated with Medicaid expansion. Specifies that these funds provide a state match for the specified amount in federal funds and provides that those federal funds are appropriated to pay for service costs associated with Medicaid expansion.

    Provides that if the amount of federal funds available to pay for service costs associated with Medicaid expansion exceeds the amounts set out in the act, then the expenditure of state funds must be reduced by an amount equal to the amount of available excess federal funds, and appropriates those excess federal funds for the described purposes.

    Makes the following reductions because of the savings generated by the expansion: (1) reduces the appropriation to DHHS, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, by $6,731,823 in recurring funds for 2017‑18 fiscal year and by $13,463,645 in recurring funds for the 2018‑2019 fiscal year and (2) reduces the appropriation for the Inmate Health Care program within the Department of Public Safety, Division of Adult Correction, by $7,884,180 in recurring funds for 2018‑19.

    Reorganizes the statutes in the Hospital Assessment Act (GS Chapter 108A, Article 7) under specified parts.

    Enacts new GS 108A-131 to make each hospital that is not fully exempt from both the equity assessment and UPL assessment under GS 108A‑122(c) subject to an additional assessment. Requires the Secretary of Health and Human Services (Secretary) to calculate the assessment amount for a hospital annually by multiplying the total state share of service and administrative costs, net of savings to other state programs, of Medicaid expansion by the hospital provider's percentage of all Medicaid services billed by all hospitals subject to the statute. Requires the Secretary to notify each hospital that is assessed of the: (1) total state share of service and administrative costs of Medicaid expansion for the applicable time period, (2) hospital's share of all Medicaid services billed, and (3) amount assessed to the hospital. Specifies that the assessment is in addition to and has greater priority than any assessment that might be collected from a hospital provider under Part 2 (UPL and Equity Assessments) of this Article and sets out requirements for when federal limitations on the total amount of Medicaid assessments that may be collected require the state to reduce the amount of assessments collected. Allows a hospital to appeal an assessment determination through a reconsideration review. 

    Amends GS 108A‑124 to make conforming changes.

    Effective July 1, 2017.


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