Bill Summary for S 408 (2021)

Summary date: 

Jun 28 2022

Bill Information:

View NCGA Bill Details2021
Senate Bill 408 (Public) Filed Tuesday, March 30, 2021
AN ACT TO DIRECT OVERSIGHT, STUDY, AND MODERNIZATION OF MEDICAID IN NORTH CAROLINA, TO ENSURE TAXPAYER SAVINGS, AND TO ENSURE ACCESS TO HEALTHCARE FOR WORKING NORTH CAROLINIANS.
Intro. by Burgin, Krawiec, Perry.

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Bill summary

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

Section 1.2

Regarding the directive to the Department of Health and Human Services (DHHS) to develop a Medicaid Modernization Plan (plan) by December 15, 2022, revises the required components of the plan to include proposed legislation for the health system assessments outlined in Section 1.6 of the act (was, any proposed necessary refinements to the health system assessments enacted in Section 1.6). Makes a similar revision to refer to the healthy system assessment outlined in Section 1.6 in the funding sources identified in the nonfederal share of the costs that must fund the expanded Medicaid coverage, for which DHHS's plan must include proposed legislation to discontinue the expanded coverage upon the identified sources' inability to fully fund the share of costs. 

Section 1.5

Eliminates the content of Section 1.5, which set hospital health advancement assessments for private acute care hospitals and public acute care hospitals for specified periods in 2023, with DHHS required to reimburse county departments of health and human services for additional costs incurred to implement the adjustments to Medicaid eligibility described in the act.

Section 1.6

Eliminates the previous content of the following sections of the act: Section 1.6, which revised Article 7B, GS Chapter 108A, the Hospital Assessment Act and enacted a new Part to the Article, statutorily providing for the public hospital health system assessment and the private hospital health system assessment; Section 1.7, which revised other provisions of the Hospital Assessment Act, including the calculation of modernized hospital assessments; and Section 1.8, which stated legislative intent to consult with stakeholders and the Division of Health Benefits (DHS) prior to the 2023 Regular Session to consider any necessary refinements to the health system assessment enacted in Section 1.6. Instead provides the following uncodified language.

States legislative intent to enact legislation creating new assessments, called health system assessments, with five intended criteria. Requires the assessments to include a public hospital health system assessment and a private hospital health system assessment calculated quarterly by DHHS as a percentage of each hospital's hospital costs, with collections to fund the nonfederal share of the costs associated with expanded Medicaid coverage with county reimbursements, and assessment collection subject to specified increased receipt and intergovernmental transfer offsets. Requires setting the historical assessment shares for private and acute hospitals based on the aggregate assessment collection amount from either public acute care hospitals or private acute care hospitals, as appropriate. 

States legislative intent to make necessary conforming changes to the Hospital Assessment Act's modernized hospital assessments, including that the assessments do not apply to newly eligible individuals, and amending the definition of federal medical assistance percentage (FMAP) to account for the applicable temporary increase of Medicaid FMAP allowed under section 9814 of ARPA. 

States legislative intent to consult with stakeholders and DHB prior to the December 15 meeting of the Joint Legislative Committee on Medicaid Rate Modernization and Savings (Committee) to develop the health system assessments outlined in the Section. 

Section 1.10

Makes conforming changes to refer to receipts anticipated from the health system assessments outlined in Section 1.6 and the proposed health system assessments outlined in Section 1.6, rather than receipts from the health system assessments enacted in Section 1.6 and the health system assessments enacted in Section 1.6.

Section 2.3

Revises the content of required reports of the Secretary of Commerce and DHHS regarding the statewide plan and referral plan, respectively, to no longer include recommended legislation to cover any State costs identified by the Secretary for the plan's implementation. Now provides legislative intent that some or all of the costs of implementation and operation to be funded through the health system assessments outlined in Section 1.6 (was, through an increase in the health system assessments enacted in Section 1.6).

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