Bill Summary for S 466 (2023-2024)

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Summary date: 

Apr 3 2023

Bill Information:

View NCGA Bill Details2023-2024 Session
Senate Bill 466 (Public) Filed Monday, April 3, 2023
AN ACT TO PROVIDE COVERAGE OF COMPREHENSIVE GENOMIC TESTING TO MEDICAID BENEFICIARIES TWENTY-ONE YEARS OLD OR YOUNGER EXPERIENCING CERTAIN ACUTE OR COMPLEX ILLNESSES.
Intro. by Perry, Lee.

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Bill summary

Includes whereas clauses.

Directs the Department of Health and Human Services, Division of Health Benefits (Division) to seek approval from the Centers for Medicine and Medicaid Services (CMS) to draw down a federal Medicaid match for coverage of comprehensive genomic testing for Medicaid beneficiaries 21 and younger. Establishes eight criteria for this coverage, including: (1) that the beneficiary is experiencing an acute or complex illness of unknown etiology as specified; (2) that the beneficiary is receiving inpatient hospital services in an intensive care unit or a high acuity pediatric care unit; (3) that genetic data generated from covered testing is primarily used for assisting the healthcare providers in the diagnosis and treatment of the beneficiary and is protected by HIPPA; and (4) the coverage begins on the date approved by CMS but no earlier than July 1, 2023.

Appropriates $500,000 in recurring funds from the General Fund to the Division for each year of the 2023-25 biennium to implement the described Medicaid coverage. Requires that the funds provide a State match for specified amounts of federal funds for each fiscal year and deems those federal funds appropriated to the Division to pay for the costs associated with the described Medicaid coverage. Effective July 1, 2023.