INMATE HEALTH CARE & 340B PROGRAM. (NEW)

View NCGA Bill Details2019-2020 Session
House Bill 106 (Public) Filed Tuesday, February 19, 2019
AN ACT TO IMPROVE INMATE HEALTH CARE REIMBURSEMENT AND INTERNAL PROCESSES AND TO ESTABLISH A TELEMEDICINE PILOT PROGRAM; IN ADDITION TO DIRECTING THE DEPARTMENT OF PUBLIC SAFETY TO PARTNER WITH THE DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR THE PURCHASE OF CERTAIN MEDICATIONS FOR INMATES, TO DIRECT THE DEPARTMENT OF PUBLIC SAFETY TO ISSUE REQUESTS FOR PROPOSALS FOR PARTNERSHIPS BETWEEN NORTH CAROLINA 340B PROGRAM ENTITIES AND THE FOUR NORTH CAROLINA PRISON REGIONS, TO DIRECT THE DEPARTMENT OF PUBLIC SAFETY TO PARTNER WITH THE UNIVERSITY OF NORTH CAROLINA HEALTH SYSTEM TO SHIFT PRESCRIBING AUTHORITY ON CERTAIN MEDICATIONS, AND TO DIRECT THE DEPARTMENT OF PUBLIC SAFETY TO SUBMIT VARIOUS REPORTS TO THE JOINT LEGISLATIVE OVERSIGHT COMMITTEE ON JUSTICE AND PUBLIC SAFETY AND THE FISCAL RESEARCH DIVISION.
Intro. by Horn, Farmer-Butterfield, Lucas, R. Turner.

Status: Ch. SL 2019-135 (Jul 19 2019)

SOG comments (2):

Identical bill

Identical to S 119, filed 2/21/19.

Long title change

Senate committee substitute to the 4th edition changed the long title. Original long title was AN ACT TO IMPROVE INMATE HEALTH CARE REIMBURSEMENT AND INTERNAL PROCESSES, AS RECOMMENDED BY THE JOINT LEGISLATIVE PROGRAM EVALUATION COMMITTEE.

Bill History:

H 106/S.L. 2019-135

Bill Summaries:

  • Summary date: Jul 22 2019 - More information

    AN ACT TO IMPROVE INMATE HEALTH CARE REIMBURSEMENT AND INTERNAL PROCESSES AND TO ESTABLISH A TELEMEDICINE PILOT PROGRAM; IN ADDITION TO DIRECTING THE DEPARTMENT OF PUBLIC SAFETY TO PARTNER WITH THE DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR THE PURCHASE OF CERTAIN MEDICATIONS FOR INMATES, TO DIRECT THE DEPARTMENT OF PUBLIC SAFETY TO ISSUE REQUESTS FOR PROPOSALS FOR PARTNERSHIPS BETWEEN NORTH CAROLINA 340B PROGRAM ENTITIES AND THE FOUR NORTH CAROLINA PRISON REGIONS, TO DIRECT THE DEPARTMENT OF PUBLIC SAFETY TO PARTNER WITH THE UNIVERSITY OF NORTH CAROLINA HEALTH SYSTEM TO SHIFT PRESCRIBING AUTHORITY ON CERTAIN MEDICATIONS, AND TO DIRECT THE DEPARTMENT OF PUBLIC SAFETY TO SUBMIT VARIOUS REPORTS TO THE JOINT LEGISLATIVE OVERSIGHT COMMITTEE ON JUSTICE AND PUBLIC SAFETY AND THE FISCAL RESEARCH DIVISION. SL 2019-135. Enacted July 19, 2019. Effective July 19, 2019, except as otherwise provided.


  • Summary date: Jun 27 2019 - More information

    Senate committee substitute to the 4th edition makes the following changes. 

    Removes the specified effective dates in GS 143B-707.5(b) and (c) of July 1, 2019, and October 1, 2019, and instead makes the entire statute (concerning Medicaid services for inmates) effective October 1, 2019. 

    Requires the report on the feasibility study of telehealth services to be made by August 1, 2019, instead of July 1, 2019.

    Adds the following.

    Requires the Department of Public Safety (DPS) to establish and implement a partnership with the Department of Health and Human Services (DHHS) in order for DPS to be eligible to operate as a 340B covered entity. Requires DPS to contract for consultant services in order to implement this section. Requires DPS to: (1) submit an application during the next registration period to enroll in the federal 340B Program to be able to access 340B Program pricing for medications used to treat the human immune deficiency virus, the hepatitis C virus, and eligible sexually transmitted diseases; (2) provide DHHS with data and necessary documentation as frequently as it is needed by DHHS; (3) ensure that DPS pharmacies are compliant dispensing pharmacies under the 340B Program; (4) coordinate with one or more vendors to purchase STD 340B Program medications that result in the greatest overall cost savings to the State; and (5) develop a separate inventory to track 340B Program medications. Requires DPS to report to the specified NCGA committee and division by October 1, 2019, on implementation of these requirements. 

    Requires DPS to develop a plan by December 1, 2019, to issue request for proposals (RFP) and sets out additional requirements of the RFP. Requires DPS to issue one RFP for each of the four prison regions. Requires the RFPs to seek partnerships between the prison regions and one or more 340B Program entities in the State and express a preference for bidding entities that would use DPS as a contract pharmacy for 340B Program medications. Requires each RFP to at least require that an entity's bid include: (1) an explanation of the bidding entity's ability to purchase the specified types of medications; (2) a commitment, as a 340B Program covered entity, to purchase medications under the 340B Program on behalf of DPS and to pass all related savings on to the State; (3) a description of the 340B Program correctional partnership model the bidding entity would use based on the seven correctional partnership models provided in the specified report; and (4) an explanation of the manner in which specialty care and 340B pharmacy services will be provided. Requires services to be provided in a manner that improves or maintains quality and continuity of patient care. Requires DPS to report to the specified NCGA committee and division by December 1, 2019, on the plan, and quarterly thereafter until RFPs for all prison regions are awarded.

    Requires DPS to partner with UNC Health Care System (UNC) by October 1, 2019, to begin receiving all 340B Program savings from medications prescribed to inmates, but not administered, at a 340B Program-registered UNC-HCS site for non-HIV and non-HCV medications. Requires DPS to direct that the prescribing authority of DPS providers be transferred to UNC providers for identified inmates treated at a 340B Program-registered UNC site. Requires that by October 1, 2019, DPS and UNC: (1) identify the UNC inmate patients for whom shifting prescriptive authority to UNC is feasible and appropriate; (2) establish a method for improving or maintaining quality and continuity of patient care once the prescriptive authority has shifted to UNC; (3) develop mechanisms to ensure that the communication between the UNC prescriber and the DPS physician maintains the quality and continuity of care that inmates currently receive; and (4) select the UNC-HCS pharmacy, the DPS Apex Central Pharmacy, or a combination of both, as the pharmacy through which medications will be dispensed.  Requires DPS and UNC to establish a Memorandum of Agreement to require UNC to pass through all of the 340B Program savings for medications specified. Requires a report to the specified NCGA committee and division by October 1, 2019, and monthly thereafter until implementation, on the progress made toward implementation. 

    Enacts new GS 143B-707.5 requiring DPS to report to the specified NCGA committee and division annually beginning October 1, 2020, on: (1) savings achieved from its partnership with DHHS for the purchasing of certain medications for inmates under the federal 340B Program; and (2) savings achieved from its partnership with UNC for the provision of inmate medications and services under the federal 340B Program. Requires DPS to report to the specified NCGA committee and division by October 1, 2021, and annually thereafter, on savings achieved from the partnerships between the four prison regions and North Carolina 340B Program entities for the provision of inmate medications and services under the Federal 340B Program.

    Changes the effective date of the act from July 1, 2019, to when the act becomes law. 

    Makes conforming changes to the act's titles.

     


  • Summary date: May 6 2019 - More information

    House committee substitute to the 3rd edition makes the following changes. 

    Eliminates the requirement for the Department of Public Safety (DPS) to include in its plan to increase the use of the Central Prison Healthcare Complex (CPHC) all expenditures for inmate health care services in a DPS, Health Services Section, budget code, and options for eliminating the inmate health care services structural deficit.

    Deletes the changes to GS 143B-707.3(a) that required that any contracts and extensions of contracts (was, extension of contracts only) for medical services provided to inmates by contracted providers and facilities include the specified reimbursement rates and required any contracts and extensions for medical services provided to inmates by contracted providers and facilities to include the specified reimbursement rates, unless greater cost savings can be demonstrated through the use of an alternative rate. 

    Makes a conforming deletion of a provision in the act's effective date that required any contracts or extension of contracts or medical services provided to inmates by contracted providers and facilities entered into by or after July 1, 2019, to include the reimbursement rates in GS 143B-707.3(a). 


  • Summary date: Apr 26 2019 - More information

    House committee substitute to the 2nd edition makes the following changes. 

    Adds to the content of the Department of Public Safety's (DPS) a plan to increase the use of Central Prison Healthcare Complex (CPHC) to require the inclusion of methods to contain costs for palliative and long-term health care services for inmates. No longer requires DPS to identify and eliminate lapsed salary positions used to fund inmate health care services for 2016-17, and transfer the salary funds to a DPS, Health Services Section (HSS), budget code. Instead, requires DPS to develop options for eliminating the structural deficit for inmate health care services, including consideration of eliminating vacant positions and transferring lapsed salary funds to the Health Services Section. No longer requires DPS to develop accounting mechanisms for inmate health care expenditures at the prison facility level. 

    Amends GS 143B-707.3 as follows. Requires any contracts and extensions for medical services provided to inmates by contracted providers and facilities to include the specified reimbursement rates, unless greater cost savings can be demonstrated through the use of an alternative rate. Deletes proposed (b1), which required the development of an electronic supply inventory management system. Instead adds a section to the bill requiring the HHS to issue two requests for proposals to develop an electronic supply inventory management system, with one RFP or a system to be used at all prison facilities and one to be for a system to be used exclusively at the Central Prison Healthcare Complex and the North Carolina Correctional Institution for Women. Sets out requirements of the management system.

    Adds the requirement that the Department of Public Safety, Health Services Section, report to the specified NCGA committees by February 1, 2020, on alternative methods for reimbursing providers and facilities that provide approved medical services to inmates. 

    Amends proposed GS 143B-707.5 to make the policies and training more specifically applicable to social workers who perform administrative activities related to Medicaid eligibility for inmates.

    Adds the requirement that HHS report to the specified NCGA committees on the feasibility study of telehealth services referenced in the February 2019 Memorandum of Agreement between DPS and UNC Health Care by July 1, 2019. Requires that the telemedicine pilot program be established with consideration of the rules of the study. Requires the pilot program to be operational by January 1, 2020 (was, October 1, 2019). Deletes the requirement that physical health services covered by the telemedicine pilot include evaluation and management activities in the specified areas. Extends the due dates of the interim and final reports on the pilot assessment criteria from October to January of 2020 and 2021.


  • Summary date: Mar 26 2019 - More information

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

    Amends proposed changes to GS 143B-707.3 to require that any contracts and extensions of contracts (was, extension of contracts only) for medical services provided to inmates by contracted providers and facilities include the specified reimbursement rates. Specifies that any contracts or extension of contracts for medical services provided to inmates by contracted providers and facilities entered into on or after July 1, 2019, must include the reimbursement rates provided in GS 143B-707.3(a). 

    Makes clarifying and organizational changes to proposed GS 143B-707.5.

    Adds that by October 1, 2019, and quarterly thereafter until full implementation is achieved, the Department of Public Safety and the Department of Health and Human Services must jointly report to the specified NCGA committees on progress in receiving federal reimbursement for performing Medicaid eligibility activities for inmates. Also requires by October 1, 2019, that the Department of Public Safety report to the specified NCGA committee on the implementation of the documentation of criteria for the submission of Medicaid applications and the electronic submission of Medicaid applications.

    Deletes the provision in Section 6 about performance measures for the telemedicine pilot program and replaces it with the following. Requires the Department of Public Safety, Health Services Section, to establish a telemedicine pilot program to provide physical health services to inmates in remote correctional facilities, to initially be established in two correctional facilities serving male inmates, one located in the eastern portion of the state and one located in the western portion. Requires consultation with specified entities and reports when designing the pilot program. Requires the pilot to connect the two correctional facility pilot sites with the Central Prison Healthcare Complex and its contracted providers' facilities and be operational by October 1, 2019. Specifies service areas that are to be included in the pilot. Requires documentation of rationale for not including any particular service area in the pilot. Specifies a non-exhaustive list of measures that are to be used to assess the pilot program. Requires an interim report on the assessment criteria by October 1, 2020, to the specified NCGA committees. Requires a report to the specified NCGA committees by October 1, 2021, on the assessment criteria and recommendations on whether to expand the pilot to additional sites. 

    Makes additional technical changes. 


  • Summary date: Feb 19 2019 - More information

    Directs the Department of Public Safety (DPS) to develop a plan to increase the use of Central Prison Healthcare Complex (CPHC) in order to contain medical costs for inmates as required by GS 143B-707.3(b) (concerning DPS reimbursement of providers and facilities providing medical services to inmates and juvenile offenders outside the facility). Specifies required components of the plan and requires DPS to submit the plan by December 1, 2019, to the specified NCGA Committee. Also requires DPS to submit progress reports regarding cost savings and increased usage of the health service facilities at CPHC and the NC Correctional Institution for Women (NCCIW).

    Additionally directs DPS to identify and eliminate lapsed salary positions used to fund inmate health care services for 2016-17, and transfer the salary funds to a DPS, Health Services Section (HSS) budget code. Further requires DPS to reflect all expenditures for inmate health care services in a DPS, HSS budget code, and develop accounting mechanisms for inmate health care expenditures at the prison facility level. Requires the above described information to be included in DPS’s plan to increase the use of the CPHC.

    Amends GS 143B-707.3. Requires DPS to reimburse the lesser amount of either a rate of 70% of the then-current prevailing charge or 100% of (was, two times) the then-current Medicaid rate for any given service, beginning July 1, 2019. Adds new requirement for DPS to reimburse providers identified as necessary to ensure continued access to care the lesser amount of either a rate of 70% of the provider’s then-current prevailing charge or 200% of the then-current Medicaid rate for any given service. Adds further requirement for any contract extensions for medical services provided to inmates by contracted providers and facilities to include the specified reimbursement rates. Requires DPS, HSS to develop an electronic supply inventory management system, meeting the minimum requirements described. Adds the reimbursement rate for contracted providers to the data included in the quarterly report. Makes the statute applicable to vendors that are not billed on a fee-for-service basis.

    Enacts GS 143B-707.5, directing DPS and the Department of Health and Human Services (DHHS) to work together to enable social workers in DPS, HSS to qualify and receive federal reimbursement for performing Medicaid eligibility activities for inmates. Requires DPS, HSS to develop policies and procedures to account for time social workers spend on Medicaid eligibility for inmates. Also requires all DPS, HSS staff who perform activities related to Medicaid eligibility to receive eligibility determination training provided by DHHS at least quarterly. Requires DPS, HSS to require social workers enter specified data when performing Medicaid eligibility activities for inmates. Adds monthly reporting requirements to the DPS, HSS Director for the social workers. Requires each DPS, HSS social worker to submit Medicaid applications and any supporting documents electronically, unless federal law requires paper copies, beginning October 1, 2019. Requires DPS and DHHS to jointly report to the specified NCGA Committee by October 1, 2019, and quarterly thereafter until full implementation, and requires DHHS to report to the specified NCGA Committee on the implementation of the documentation of criteria for Medicaid application submissions by October 1, 2019.

    Directs DPS, HSS and the Office of State Human Resources to study the salaries of all in-prison health services employees to determine necessary adjustments to increase new hire and existing salaries to market rates. Further directs DPS to establish a vacancy rate benchmark for each correctional facility and create a plan to reduce vacancy rates, including considering the seven identified initiatives. Requires DPS to establish methods to measure effectiveness of the initiatives to reduce vacancy rates and estimate budgetary impact and anticipated savings, and submit its findings by February 1, 2020, to the specified NCGA Committee.

    Directs DPS, HSS to establish performance measures for its current telemedicine pilot program to inform a business case for potential expansion of the pilot program and propose an implementation plan to expand the use of telemedicine with accompanying cost savings. Requires DPS, HSS to report by April 1, 2020, and annually thereafter, on its business case for telemedicine to the specified NCGA Committee. Prohibits DPS, HSS from expanding the pilot program until the results of the current pilot program can be demonstrated and reported to the General Assembly.

    Effective July 1, 2019.


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