Bill Summary for S 808 (2019-2020)

Summary date: 

Jun 10 2020

Bill Information:

View NCGA Bill Details2019-2020 Session
Senate Bill 808 (Public) Filed Tuesday, May 19, 2020
AN ACT APPROPRIATING FUNDS FOR THE DOROTHEA DIX CAMPUS RELOCATION PROJECT AND FOR NORTH CAROLINA FAMILIES ACCESSING SERVICES THROUGH TECHNOLOGY (NC FAST); APPROPRIATING CORONAVIRUS RELIEF FUNDS FOR BEHAVIORAL HEALTH AND CRISIS SERVICES, EARLY CHILDHOOD INITIATIVES, AND COVID-19 TESTING, CONTACT TRACING, AND TRENDS TRACKING AND ANALYSIS; APPROPRIATING FUNDS FOR THE OPERATION OF THE NORTH CAROLINA MEDICAID PROGRAM AND THE IMPLEMENTATION OF MEDICAID TRANSFORMATION; AND MAKING MEDICAID TRANSFORMATION-RELATED CHANGES.
Intro. by Brown, Harrington, B. Jackson.

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Bill summary

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

Makes organizational changes to existing content. Modifies existing content and adds new content as follows.

Part I

Transfer $15 million in nonrecurring funds from the General Fund to the State Capital and Infrastructure Fund, and appropriates the transferred funds to the Office of State Budget and Management (OSBM) for 2020-21 to be allocated for the Dorothea Dix campus relocation project with the Department of Health and Human Services (DHHS). Directs the Department of Administration to collaborate with DHHS to select land in Wake County suitable for the relocation project, with the appropriated funds to be used for planning expenses. Effective July 1, 2020.

Part II

Appropriates $6,154,480 in nonrecurring funds from the General Fund to DHHS, Division of Central Management and Support for 2020-21 for updates and changes to the child welfare case management component of the NC Families Accessing Services through Technology (NC FAST) system, as specified. Effective July 1, 2020.

Part III

Directs the State Controller to transfer $50 million from the Coronavirus Relief Reserve to the Coronavirus Relief Fund (both established in SL 2020-4), and appropriates the transferred funds on a nonrecurring basis to OSBM for 2020-21 to allocated to DHHS, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (DMH/DD/SAS) for distribution LME/MCOs to fund behavioral health and crisis services in response to the COVID-19 pandemic at the discretion of DMH/DD/SAS. Makes the general provisions set out in Part I of SL 2020-4 applicable to the appropriated funds and requires OSBM to include the funds transferred and appropriated in the report required under Section 1.7 of SL 2020-4. Effective July 1, 2020.

Part IV

Explicitly prohibits DHHS, Division of Health Benefits (DHB) from transferring any amount of the certified Medicaid budget surplus calculated for 2019-20 to DMH/DD/SAS for allocation to LME/MCOs to offset any reduction in single-stream funding. Effective June 30, 2020.

Part V

Requires described funds received by DHB during 2019-20 due to the acceleration of the federal 2019-20 MRI/GAP Plan to remain available and used for the Medicaid Program for the 2020-21 fiscal year. Effective June 30, 2020.

Appropriates from the General Fund to DHB $1.4 million in nonrecurring funds for 2020-21 for the implementation of an electronic visit verification (EVV) system for personal care services and home health services under the Medicaid program. 

Provides for the following funding for Medicaid and NC Health Choice programs rebase.

Requires $30 million in nonrecurring funds of the funds appropriated to DHB for 2019-20 and the funds appropriated in Part V of the act to remain available to be used for the Medicaid and NC Health Choice programs rebase in the 2020-21 fiscal year. Effective June 30, 2020.

Directs the State Controller to transfer $84 million from the funds available in the Medicaid Transformation Reserve to DHB for 2020-21 to be used for Medicaid and NC Health Choice programs rebase. Deems these funds appropriated for the stated purpose.

Directs $136 million in nonrecurring funds to be transferred from the Medicaid Contingency Reserve to DHB for 2020-21 to be used for the Medicaid and NC Health Choice programs rebase. Deems funds appropriated for the stated purpsoe.

Appropriates $213 million from the General Fund to DHB for 2020-21 to be used for the Medicaid and NC Health Choice programs rebase.

Effective July 1, 2020, except as otherwise provided.

Part VI

Directs every county department of social services and any federally recognized tribe that has assumed responsibility for the Medicaid program to take the following actions within 60 days after expiration of the declared nationwide public health emergency as a result of COVID-19: (1) redetermine Medicaid eligibility for all beneficiaries whose eligibility was continued by federal law but were due for renewal of eligibility, experienced a change in circumstance affecting eligibility, or post-eligibility verification information affected eligibility; and (2) provide notice to beneficiaries determined ineligible as a result of such redetermination.

Part VII

Contains the substantive content of the 1st edition, with the following modifications and additions.

Section 7

Amends Section 3 of SL 2015-245, as amended, to require capitated contracts to begin no later than July 1, 2021, rather than January 1, 2021.

Provides that if the capitated payments do not begin on July 1, 2021, DHB must make the following monthly payments to prepaid health plans (PHPs) for each full month after June 30, 2021, that the payments have not been paid. Requires $4 million to each PHP that has been awarded a statewide benefit plan PHP capitated contract as of June 1, 2020, and a prorated amount of $4 million to each PHP that has been awarded a regional standard benefit plan PHP capitated contract as of June 1, 2020, based upon the number of regions contracted to serve. Excludes months in which capitation payment failure after July 1, 2021, is caused by the PHP.

Eliminates the previous appropriations provisions regarding funding for the Medicaid and NC Health Choice programs rebase and contracts, personnel, and projects relating to transitioning to Medicaid managed care.

Section 8

Modifies the required transfers of unspecified amounts for Medicaid transformation. Now requires the State Controller to transfer $19.42 million from funds in the Medicaid Transformation Reserve to the Medicaid Transformation Fund (Transformation Fund), and allows the sum to be transferred to DHB on a nonrecurring basis for 2020-21, as qualifying needs arise, for the sole purpose of providing the State share for qualifying needs directly related to Medicaid transformation. Adds provider experience as a qualifying need, and no longer includes other nonrecurring needs identified by DHB as a qualifying need. Now requires OSBM to verify that the amount DHB requests provides a State share that does not result in a total requirement exceeding $63,120,000 for 2020-21 (was, $140 million). 

Adds that the Section is effective July 1, 2020.

Section 11

Sets the rate floor for durable medical equipment under managed care at 100% of the Medicaid fee-for-service for durable medical equipment for the first three years of the initial standard benefit plan prepaid health plan capitated contracts required under Article 4 of GS Chapter 108D.

Section 12

Makes clarifying changes regarding services that DHHS may contract with IMCE/IHCPs to provide Medicaid and NC Health Choice beneficiaries.

Section 13

Changes the effective date of the previously described changes to the supplemental payment program for eligible medical providers from January 1, 2021, to July 1, 2021.

Changes the effective date of the proposed repeal of Section 12H.13(e) of SL 2013-360, which reduced the percentage of allowable costs for hospital payments from 80% to 70%, and Sections 12H.13(b) and 12H.13A of SL 2014-100, which set the settlement for outpatient Medicaid services performed by UNC Hospitals and Vidant Medical Center at 70% of costs, from January 1, 2021, to July 1, 2021.

Section 15.1

Changes the effective date of the proposed repeal of Article 7 of GS Chapter 108A, Hospital Provider Assessment Act, from January 1, 2021, to July 1, 2021. 

Makes the following modifications to the specified assessments and payments required under Article 7 of GS Chapter 108A due prior to the Article's repeal. For the annual period beginning October 1, 2020, requires calculation of the equity payment amount and the UPL payment amount required by GS 108A-124 to exclude services rendered after June 30, 2021, rather than December 31, 2020. 

Changes the effective date of proposed new Article 7A, Hospital Assessment Act, in GS Chapter 108A, from January 1, 2021, to July 1, 2021.

Changes the definition given for the State's annual Medicaid payment, now calculated at a base of $120 million for the taxable year October 1, 2020, through September 30, 2021, rather than $110 million.

Regarding required transfers from hospitals exempt from both the base and supplemental assessments that (1) make an intergovernmental transfer to the DHHS to be used to draw down matching federal funds and (2) has acquired, merged, leased, or managed another hospital on or after March 25, 2011, modifies the partial year formula set out for calculating the required amount to now require, for the period beginning July 1, 2021, rather than January 1, 2021, and ending September 30, 2021, dividing one-fourth of the amount of the State's annual Medicaid payment (was, three-fourths) by the amount collected under the base assessment.

Requires total hospital costs to be calculated based on the Hospital Cost Report Information System's 2017, rather than 2016, cost report data available through CMS for the taxable year October 1, 2020, through September 30, 2021.

Changes the base and supplemental assessment percentage rates to be used pursuant to new GS 108A-142 and GS 108A-141 for the taxable year October 1, 2020, through September 30, 2021, at a base assessment rate of 2.04% (was 1.77%) and a supplemental assessment rate of 2.32% (was 2.26%). Restricts imposition of the base assessment rate and the supplemental assessment rate to the months beginning on or after July 1, 2021, rather than January 1, 2021, with the assessment imposed from the period July 1, 2021 (was January 1, 2021), through September 30, 2021, to be one-quarter, rather than three-fourths, of the assessment amount that would have been imposed for the full taxable year.

Postpones the sunset of the authority granted to the the State Controller to transfer funds from the Medicaid Contingency Reserve to DHB upon request and as needed to cover any shortfall of receipts from the supplemental or base assessments under new GS 108A-141 and GS 108A-142, from June 30, 2021, to June 30, 2022.

Section 18

States the NCGA's intent to enact legislation before the start of the 2021-22 fiscal year, rather than to amend Section 2.3(b) of SL 2019-242, to reflect changes to the handling of nontax revenue in the NC Medicaid program in a managed care environment.

Part VIII

Contains the general provisions set forth in previous Part I of the act.

Changes the act's titles.

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