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NCARF

Legislative Session 2017: 

March Update:

North Carolina:

After an extended 2017 long session, we are now officially adjourned and are prepping for short session 2018. The North Carolina General Assembly will return to Raleigh on May 16, 2018 to begin the next round of discussions on our state budget, possible changes to Medicaid transformation including a BH/IDD tailored plan and addressing education policy possibly including school safety measures. We are also in election 2018. All seats in the North Carolina General Assembly will be on the ballot in 2018. Primaries in our state are scheduled for May 8, 2018.  It is going to be a very busy 2018 and here are some key policy snapshots from the past few weeks.

 Next Meetings of Interest at North Carolina General Assembly:
 
Tuesday, March 13, 2018
9:00AM Joint Legislative Oversight Committee on Health and Human Services 643 LOB
1:00PM Joint Legislative Oversight Committee on Medicaid and NC Health Choice 643 LOB
 
Wednesday, March 28, 2018
12:00 Noon Committee on Intellectual and Developmental Disabilities (LRC) 544 LOB
 
Please visit www.ncleg.net for links to committees and to find audio of the meetings. All committee meetings listed on the calendar are open to the public.
 
 
Medicaid Budget Update:

Medicaid budget continues to track on target. As of January 24, 2018, the Department of Health and Human Services reports an expected surplus in the current year of $28.1 million in state appropriations. DHHS expects Requirements to be $149.8 million over budget but with $177.9 million higher in expected receipts budget remains on target for 2017-2018 fiscal year.

https://www.ncleg.net/documentsites/committees/BCCI-6660/Meetings%20by%20Interim/2017-2018%20Interim/February%2028,%202018/Item%204%20Medicaid%20Dashboards%202-28-2018.pdf
 
 
Legislative Oversight Committee Updates: Medicaid/Health and Human Services:

DHHS presented two key updates to oversight committees on February 28, 2018. The key takeaway from the HHS Oversight Committee was an update on the status of Cardinal Innovations. Secretary Cohen told committee members of the Joint Health and Human Services Oversight Committee that DHHS has transitioned leadership and governance to a new board of directors. Cardinal has committed to invest $3.8 million in community investments. DHHS has completed board training and a plan of correction has been approved.

https://www.ncleg.net/documentsites/committees/JLOCHHS/Handouts%20and%20Minutes%20by%20Interim/2017-18%20Interim%20JLOC-HHS%20Handouts/February%2028,%202018/II%20JLOC-HHS_DHHSUpdates_20180228_AM.pdf
 
 
The Joint Legislative Oversight Committee on Medicaid were presented information regarding an update on the state’s Medicaid budget and also the status of the 1115 waiver. Quick background: DHHS has submitted an 1115 waiver to CMS. The waiver was amended to include a BH/IDD Tailored Benefit Plan, Carolina Cares, Workforce Innovation Program and other policy items that had not been in previous bills passed by the North Carolina legislature. CMS has not yet approved the waiver. The Joint Legislative Oversight Committee on Medicaid heard a detailed presentation regarding the difference between the legislation passed and the 1115 waiver amendment. Members were also updated on the current Medicaid budget which remains on target for fiscal year 2017-2018.

https://www.ncleg.net/documentsites/committees/BCCI-6660/Meetings%20by%20Interim/2017-2018%20Interim/February%2028,%202018/Item%207A%20Medicaid%20Waiver%202-28-2018v2.pdf
 
https://www.ncleg.net/documentsites/committees/BCCI-6660/Meetings%20by%20Interim/2017-2018%20Interim/February%2028,%202018/Item%207B%20JLOC_MedNCHC_1115_20180228_PM.pdf
 
 
LRC on I/DD Employment:

March started with a second meeting of the Committee on Intellectual and Developmental Disabilities. The first meeting included presentations by state agencies including DHHS, DPI, the Community College system and the University system. The second meeting opened with a presentation by the NC Department of Health and Human Services to respond to specific questions from members including funding streams that provide supported employment opportunities for people with I/DD. The committee also invited advocacy organizations and providers to present. The focus of these presentations were transition and employment as well as what gaps or needs there are in the system. There will be two more meetings of the committee, March 28th and in April.

https://www.ncleg.net/gascripts/committees/committees.asp?sAction=ViewCommittee&sActionDetails=Non-Standing_6711
 
 
New Concept Papers/RFP Process Begins:

The Department of Health and Human Services is continuing to release concept papers and has released the first RFP related to Medicaid transformation. The first RFP is to contract with an independent enrollment broker. This broker will be a third-party vendor with no conflict of interest with potential prepaid health plans.  The enrollment broker is a requirement under CMS Medicaid Managed Care Final rule that does require states to implement an independent beneficiary support system. This enrollment broker will work with County DSS offices who continue to be responsible for Medicaid eligibility.

You can view the RFP here:
https://www.ips.state.nc.us/ips/AGENCY/PDF/12346300.pdf
 
 
Newest Concept Paper is Managed Care Benefits and Clinical Coverage Policies

This concept paper focuses on the intent of DHHS to provide a benefit plan that reflects an integrated and whole person approach to the needs of beneficiaries. Included in the concept paper is a more detailed look at what supports and services will be included in both a standard plan and a BH/IDD tailored plan. The Department of Health and Human Services is also accepting feedback on this concept paper.
You can read the paper here: https://files.nc.gov/ncdhhs/documents/Benefits-CCP_ConceptPaper_FINAL_20180302.pdf
 
 
Bills Eligible for Short Session 2018:


As we get ready for legislative short session, here are the bills that are eligible for committees to take up.

https://www.ncleg.net/documentsites/legislativepublications/Legislative%20Analysis%20Division/Eligible%20Bills/Bills%20Eligible%20for%20Consideration%20for%202018%20Session.pdf
 
 
National:

Several states have been receiving 1115 waiver approvals for Medicaid work requirements. Kaiser Family has provided an excellent resource for information on this CMS change.

https://www.kff.org/medicaid/issue-brief/medicaid-and-work-requirements-new-guidance-state-waiver-details-and-key-issues/
https://khn.org/news/cms-issues-split-decision-on-arkansas-medicaid-waiver/
 
Other News:

Amazon offers a discount for Amazon Prime for Medicaid recipients.

https://abcnews.go.com/Technology/wireStory/amazon-offers-prime-membership-discount-medicaid-users-53578713
 
USA Today article on work requirements and Medicaid.
https://www.usatoday.com/story/opinion/2018/03/07/new-medicaid-work-requirements-worse-health-less-work-people-disabilities-marty-ford-column/397291002/

LEGISLATIVE UPDATES

NC General Assembly; Who Represents Me?

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LEGISLATIVE UPDATES FROM JULIA ADAMS-SCHRURICH