IMPROVING NC RURAL HEALTH (NEW).

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View NCGA Bill Details2017-2018 Session
House Bill 998 (Public) Filed Wednesday, May 23, 2018
AN ACT TO DIRECT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO STUDY AND REPORT RECOMMENDATIONS TO CREATE INCENTIVES FOR MEDICAL EDUCATION IN RURAL AREAS OF THE STATE AND TO ASSIST RURAL HOSPITALS IN BECOMING DESIGNATED AS TEACHING HOSPITALS BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES; TO DIRECT THE OFFICE OF RURAL HEALTH, DEPARTMENT OF HEALTH AND HUMAN SERVICES, TO ENSURE ITS LOAN REPAYMENT PROGRAM IS TARGETED TO BENEFIT HEALTH CARE PROVIDERS IN RURAL NORTH CAROLINA, INCLUDING IDENTIFYING AND MAKING RECOMMENDATIONS TO ADDRESS THE NEED FOR DENTISTS IN RURAL AREAS; AND TO IMPROVE ACCESS TO DENTAL CARE IN RURAL NORTH CAROLINA; AND TO DIRECT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO STUDY MEDICAID HEALTH OUTCOMES PROGRAMS.
Intro. by Lewis, Murphy, White, Hunter.
Status: Ch. SL 2018-88 (House Action) (Jun 25 2018)

SOG comments (4):

Identical bill

Submitted by jhenders@sog.unc.edu on

Identical to S 742, filed 5/23/18.

Short and Long Title Changes

Submitted by Penny.Griffin@n... on

House committee substitute to the 1st edition makes changes to the short and long titles. The original titles are as follows:

GME/RURAL HOSPITAL STUDY.

AN ACT DIRECTING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO STUDY AND REPORT RECOMMENDATIONS TO CREATE INCENTIVES FOR MEDICAL EDUCATION IN RURAL AREAS OF THE STATE AND TO ASSIST RURAL HOSPITALS IN BECOMING DESIGNATED AS TEACHING HOSPITALS BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, AS RECOMMENDED BY THE LEGISLATIVE RESEARCH COMMISSION.

Long Title Change

Submitted by Penny.Griffin@n... on

House amendments to the 2nd edition make changes to the long title. The original title is as follows:

AN ACT DIRECTING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO STUDY AND REPORT RECOMMENDATIONS TO CREATE INCENTIVES FOR MEDICAL EDUCATION IN RURAL AREAS OF THE STATE AND TO ASSIST RURAL HOSPITALS IN BECOMING DESIGNATED AS TEACHING HOSPITALS BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES; TO DIRECT THE OFFICE OF RURAL HEALTH, DEPARTMENT OF HEALTH AND HUMAN SERVICES, TO ENSURE ITS LOAN REPAYMENT PROGRAM IS TARGETED TO BENEFIT HEALTH CARE PROVIDERS IN RURAL NORTH CAROLINA, INCLUDING IDENTIFYING AND MAKING RECOMMENDATIONS TO ADDRESS THE NEED FOR DENTISTS IN RURAL AREAS; AND TO DIRECT THE PROGRAM EVALUATION DIVISION TO STUDY THE STATE HEALTH PLAN AND TO DIRECT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO STUDY CHANGES TO THE MEDICAID PROGRAM THAT WILL INCREASE PREVENTATIVE HEALTH SERVICES, IMPROVE HEALTH OUTCOMES, AND LOWER THE COST OF CARE.

Long title change

Submitted by wunsche@sog.unc.edu on

Senate committee substitute to the 3rd edition amends the act's long title. The title was: AN ACT DIRECTING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO STUDY AND REPORT RECOMMENDATIONS TO CREATE INCENTIVES FOR MEDICAL EDUCATION IN RURAL AREAS OF THE STATE AND TO ASSIST RURAL HOSPITALS IN BECOMING DESIGNATED AS TEACHING HOSPITALS BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES; TO DIRECT THE OFFICE OF RURAL HEALTH, DEPARTMENT OF HEALTH AND HUMAN SERVICES, TO ENSURE ITS LOAN REPAYMENT PROGRAM IS TARGETED TO BENEFIT HEALTH CARE PROVIDERS IN RURAL NORTH CAROLINA, INCLUDING IDENTIFYING AND MAKING RECOMMENDATIONS TO ADDRESS THE NEED FOR DENTISTS IN RURAL AREAS; AND TO DIRECT THE PROGRAM EVALUATION DIVISION TO STUDY THE STATE HEALTH PLAN AND TO DIRECT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO STUDY CHANGES TO THE MEDICAID PROGRAM THAT WILL INCREASE PREVENTATIVE HEALTH SERVICES, IMPROVE HEALTH OUTCOMES, AND LOWER THE COST OF CARE; AND TO IMPROVE ACCESS TO DENTAL CARE IN RURAL NORTH CAROLINA.

Bill History:

H 998/S.L. 2018-88

Bill Summaries:

  • Bill H 998 (2017-2018)
    Summary date: Jun 26 2018 - View Summary

    AN ACT TO DIRECT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO STUDY AND REPORT RECOMMENDATIONS TO CREATE INCENTIVES FOR MEDICAL EDUCATION IN RURAL AREAS OF THE STATE AND TO ASSIST RURAL HOSPITALS IN BECOMING DESIGNATED AS TEACHING HOSPITALS BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES; TO DIRECT THE OFFICE OF RURAL HEALTH, DEPARTMENT OF HEALTH AND HUMAN SERVICES, TO ENSURE ITS LOAN REPAYMENT PROGRAM IS TARGETED TO BENEFIT HEALTH CARE PROVIDERS IN RURAL NORTH CAROLINA, INCLUDING IDENTIFYING AND MAKING RECOMMENDATIONS TO ADDRESS THE NEED FOR DENTISTS IN RURAL AREAS; AND TO IMPROVE ACCESS TO DENTAL CARE IN RURAL NORTH CAROLINA; AND TO DIRECT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO STUDY MEDICAID HEALTH OUTCOMES PROGRAMS. Enacted June 25, 2018. Section 6(b) is effective October 1, 2018. The remainder is effective June 25, 2018.

    Education, Higher Education, Government, General Assembly, State Agencies, Department of Health and Human Services, Health and Human Services, Health, Health Care Facilities and Providers, Health Insurance, Social Services, Public Assistance
    STUDY, GS 90
  • Bill H 998 (2017-2018)
    Summary date: Jun 13 2018 - View Summary

    Senate committee substitute makes the following changes to 3rd edition. Amends the act's long title. Deletes Part III, directing the study of the State Health Plan and Medicaid program. Amends GS 90-36, deleting entirety of subsection (e), which required a dentist to timely enter practice and only practice in North Carolina. Makes conforming change. Effective October 1, 2018. Adds new Section V, directing the Department of Health and Human Services to conduct a study and propose two coordinated quality outcomes programs requiring the state's transformed Medicaid delivery system to be built on defined measures and goals for risk-adjusted health outcomes. Requires one program to address acute care hospitals participating in the State Medicaid program and the other program to apply to all Medicaid prepaid health plans in the State. Requires report on these plans by October 1, 2018, to the Joint Legislative Oversight Committee on Medicaid and NC Health Choice. 

    Education, Higher Education, Government, General Assembly, State Agencies, Department of Health and Human Services, Health and Human Services, Health, Health Care Facilities and Providers, Health Insurance, Social Services, Public Assistance
    STUDY, GS 90
  • Bill H 998 (2017-2018)
    Summary date: Jun 11 2018 - View Summary

    House amendments make the following changes to 2nd edition. Amends title to include language regarding improving access to dental care in rural North Carolina and the study of the impact of the Medicaid program on rural economies and resident's health.

    Amendment #5 adds new Section 5, requiring the Department of Health and Human Services to study the impact of the Medicaid program on the health of individuals residing in rural areas of the state and economies of those areas. The study must include possible changes to the Medicaid program that would increase preventative health services and lower the overall cost of care, and an evaluation of the direct primary care model. Specifies four items that must be determined in the study. The report must be submitted to the Joint Legislative Oversight Committee on Medicaid and NC Health Choice by October 1, 2019. 

    Amendment #3 adds new Section 6. Adds a statement about the benefit of expediting the licensing of dentists in states that border NC.

    Amends GS 90-36, concerning licensing dentists from other states, requiring the State Board of Dental Examiners to issue a dentist license by credentials to any applicant who holds a current license and is in good standing in a state bordering North Carolina that will also issue a license by credentials to a dentist licensed in North Carolina. A dentist seeking admission in this manner must otherwise fulfill the standard conditions for licensure in the State. Removes requirement that a licensed dentist must establish a practice location and actively practice dentistry in the state within one year of licensure. Effective October 1, 2018. 

    Education, Higher Education, Government, General Assembly, State Agencies, Department of Health and Human Services, Health and Human Services, Health, Health Care Facilities and Providers, Health Insurance, Social Services, Public Assistance
    STUDY, GS 90
  • Bill H 998 (2017-2018)
    Summary date: Jun 7 2018 - View Summary

    House amendment amends the 2nd edition to require the evaluation of the State Health Plan by the Program Evaluation Committee pursuant to Section 4 of the act to include determining the contract options for improving primary care provider (was, primary care physician) quality of life in a rural setting that include a direct primary care type payment model. 

    Education, Higher Education, Government, General Assembly, State Agencies, Department of Health and Human Services, Health and Human Services, Health, Health Care Facilities and Providers, Health Insurance, Social Services, Public Assistance
    STUDY
  • Bill H 998 (2017-2018)
    Summary date: Jun 6 2018 - View Summary

    House committee substitute makes the following changes to the 1st edition.

    Changes the act's long and short titles.

    Places the previous provisions into Part I.

    Adds Part II. Directs the Office of Rural Health to structure the NC State Loan Repayment Program to align with three specific goals: (1) increase the number of healthcare providers in rural areas; (2) coordinate with the National Health Service Corps and Federal Loan Repayment programs, and any other publicly or privately funded programs, to maximize funding to increase the number of healthcare providers in rural areas; and (3) encourage the recruitment and retention of healthcare providers in rural areas.

    Further directs the Office of Rural Health to work with data from the Cecil G. Sheps Center for Health Services Research as well as other sources to identify the need for dentists in rural areas, and develop a recommendation to target loan repayment funds for dentists in rural areas that have been identified as having the greatest need.

    Requires the Office of Rural Health to submit an interim report on or before October 1, 2018, and a final report on or before October 1, 2019, to the Joint Legislative Oversight Committee on Health and Human Services.

    Adds Part III. Directs the Joint Legislative Program Evaluation Oversight Committee to include in the work plan of the Program Evaluation Division (Division) an evaluation of the State Health Plan, with the goal of determining whether there are changes that will increase preventative health services, improve health outcomes, and lover the overall cost of healthcare. Requires the Division to include an evaluation of the direct primary care model in its study. Specifically requires the Division to determine: (1) the contract options for improving primary care physician quality of life in a rural setting that include but are not limited to a direct primary care type payment model and (2) the total cost implications and legislation needed to implement recommendations. Directs the Division to submit a report to the Joint Legislative Program Evaluation Oversight Committee on or before March 1, 2019.

    Similarly, directs the Department of Health and Human Services (DHHS) to study whether there are changes to the State Medicaid Program that will increase preventative health services, improve health outcomes, and lower the overall cost of healthcare. Requires DHHS to include an evaluation of the direct primary care model in its study. Specifically requires DHHS to determine: (1) the relationship of options to outcome measures that will be included in the Prepaid Health Plan contracts under the transformed Medicaid program, (2) the contract options for improving primary care physician quality of life in a rural setting that include but are not limited to a direct primary care type payment model, and (3) the total cost implications and legislation needed to implement recommendations. Directs DHHS to submit a report to the Joint Legislative Oversight Committee on Medicaid and NC Health Choice on or before October 1, 2019.

    Education, Higher Education, Government, General Assembly, State Agencies, Department of Health and Human Services, Health and Human Services, Health, Health Care Facilities and Providers, Health Insurance, Social Services, Public Assistance
    STUDY
  • Bill H 998 (2017-2018)
    Summary date: May 23 2018 - View Summary

    Directs the Department of Health and Human Services (DHHS) to study, identify options, and make recommendations to incentivize rural healthcare providers to participate in medical education programs exposing medical residents to rural areas, programs, and populations, and support medical education and medical residency programs that meet the State’s healthcare needs. Allows DHHS to collaborate with the North Carolina Area Health Education Centers Program. Specifically requires DHHS to examine: (1) changes in Medicaid graduate medical education reimbursement and funding sources after the 1115 Medicaid waiver submitted by DHHS to Centers for Medicare and Medicaid Services is approved, (2) options to coordinate with the NC Area Health Education Centers funding to attract residents and students to rural areas of the State, and (3) other issues DHHS deems appropriate. Requires DHHS to report to the Joint Legislative Oversight Committee on Health and Human Services and the Joint Legislative Oversight Committee on Medicaid and NC Health Choice by October 1, 2018, including specific, actionable steps that can be implemented and the estimated costs and timetable for implementation.

    Directs DHHS to identify rural hospitals that wish to be designated as new teaching hospitals by the Centers for Medicare and Medicaid Services, and evaluate the technical assistance and expected costs required in order for those hospitals to be so designated. Requires DHHS to collaborate with external professionals with experience and expertise in the establishment of new teaching programs, expanding existing programs, and maximizing the effectiveness of funding for medical education, particularly in rural areas. Specifically requires DHHS to examine: (1) the expansion of graduate medical education payments to outpatient costs and services, (2) modifications to cost-finding and reimbursement formulas that incentivize participation, (3) options in physician reimbursement to incentivize participation, and (4) other issues DHHS deems appropriate. Requires DHHS to submit an interim report by October 1, 2018, and a final report by October 1, 2019, to the Joint Legislative Oversight Committee on Health and Human Services and the Joint Legislative Oversight Committee on Medicaid and NC Health Choice.

    Education, Higher Education, Government, State Agencies, Department of Health and Human Services, Health and Human Services, Health, Health Care Facilities and Providers
    STUDY
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