NCGA Week in Review: A Spotlight on Healthcare

July 27, 2018

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The General Assembly returned to Raleigh on Tuesday, July 24, 2018 for a special session. The purpose of the special session was to allow members to write the language that would appear on the ballot for constitutional amendments this November. Members also had the option to consider any other bills they deemed necessary. The special session produced two bills that have been sent to Governor Cooper for his consideration. The Governor now has less than 10 days to veto or sign HB 3: Ballot Designations/Referenda and SB 3: Party Disclosure/2018 Judicial Races. If vetoed, the General Assembly is expected to return to override the vetoes using their supermajority.

The North Carolina General Assembly considered several healthcare issues during the 2018 legislative short session. Below is a list of spotlighted bills that became law, as well as a list of bills that were filed in 2018, but did not become law.

Bills that became law in 2018

This section includes a sampling of healthcare-related bills that became law this year, but is not all-inclusive. To see all bills that became law during this biennium, click here.

HB 156: Medicaid PHP Licensure & Transformation Modifications
An act to require Medical prepaid health plans to obtain a license from the Department of Insurance and to make other changes pertaining to Medicaid Transformation and the Department of Insurance. Unless otherwise stated, effective upon signature into law, June 22,2018.

Provisions of interest includes:

  • Establishes the “Prepaid Health Plan Licensing Act,” which sets out the requirements for the licensure of prepaid health plans by the Department of Insurance as part of the state’s transition of the Medicaid program from fee-for-service to managed care.
  • Amends the timeline for Medicaid transformation, which was originally established in S.L. 2015-245 and amended in S.L. 2016-121.
  • Modifies the role and responsibilities of DHHS during the Medicaid transformation.
  • Sets out which sections of Chapter 58, which regulates health benefit plans and insurers, shall apply to the Medicaid managed care plans. 

HB 277: Naturopathic Study
An act to establish a work group to make recommendations for appropriate oversight and regulation of the practice of naturopathic medicine in North Carolina and to report to the Joint Legislative Oversight Committee on Health and Human Services. Effective upon signature into law, June 22, 2018, and report is due on or before June 15, 2019.

HB 382: DOI Omnibus
An act to incorporate National Association of Insurance Commissioners (NAIC) model language into NC’s Life and Health Insurance Guaranty Association Act; to amend and make clarifying changes to the Surplus Lines Act; to amend Consent to Rate and Captive Insurance laws; and to amend and make technical changes to other insurance laws, as recommended by the Department of Insurance. Effective upon signature into law on June 28, 2018.

HB 403: Medicaid & Behavioral Health Modifications
An act to modify the Medicaid Transformation legislation. Effective upon signature into law, June 22, 2018.

Makes changes to  S.L. 2015-245 (the original Medicaid Transformation legislation), which was subsequently amended by S.L. 2016-121, S.L. 2017-57, and S.L. 2017-186, including:

  • Modifies the definition of a Prepaid Health Plan (PHP) to include a LME/MCO that operates, or will operate, a behavioral health IDD Tailored Plan.
  • Requires LME/MCOs to cease managing Medicaid services for all Medicaid recipients, with exceptions, that capitated contracts begin.
  • Sets out the terms for the implementation of behavioral health IDD Tailored Plans by DHHS.

HB 741: DHHS Study/Maternal and Neonatal Care
An act directing DHHS to study issues pertaining to high-quality, risk-appropriate maternal and neonatal care and to allow simultaneous cremation of certain fetuses and infants. Effective upon signature into law, June 25, 2018.

HB 998: Improving NC Rural Health
An act to direct DHHS to study and report recommendations to create incentives for medical education in rural areas of the state and to assist rural hospitals in becoming designated as teaching hospitals by CMS; to direct the Office of Rural Health of DHHS to ensure its loan repayment program is targeted to benefit health care providers in rural NC, including identifying and making recommendations to address the need for dentists in rural areas; and to improve access to dental care in rural NC; and to direct DHHS study Medicaid health outcomes programs. Effective upon signature into law, June 25, 2018, other than Section 6(b), pertaining to dental inter-jurisdictional licensure, which is effective on October 1, 2018.

SB 99: Appropriations Act of 2018
An act to modify the current operations Appropriations Act of 2017 and to make other changes in the budget operations of the State. Effective July 1, 2018, unless otherwise stated.

Provisions of note within the Department of Health and Human Services part of the budget includes:

  • Adds three new screening tests to the infant genetic testing screening panel and raises the cost of the test to $128 to cover the additional screenings.
  • Directs $300,000 in recurring funds to be transferred to the ALE for the performance of statewide compliance checks in order to enforce the State’s youth tobacco access law. Also provides additional non-recurring dollars for two smoking cessation programs and youth tobacco prevention.
  • Requires DHHS to submit a State Plan amendment to CMS in order to establish Medicaid reimbursement for ambulance transports of Medicaid recipients in behavioral health crises to behavioral health clinics or other appropriate locations.
  • Requires DHHS to submit a follow-up report to the NCGA on expanding the Program of All-Inclusive Care for the Elderly (PACE) by December 1, 2018. The report will include options for expansion, the impact of expansion to unserved and underserved counties, and the potential options for delivery of care and the savings that each of those options could present to the State.

Increases the number of medical professional providers eligible for supplemental payments by 60 and requires DHHS to submit a report to the NCGA on how this increase will increase access to health care in rural areas of NC. 

SB 616: Heroin & Opioid Prevention & Enforcement Act
An act amending laws pertaining to the NC Controlled Substances Act and the NC Controlled Substances Reporting System Act, including the revision and establishment of penalties for certain violations, and expressing the intent to appropriate additional funds in the future for community-based substance use disorder treatment and recovery services, the purchase of overdose medications, Operation Medicine Drop, and special agent position within the State Bureau of Investigation, and to amend the statewide telepsychiatry program that delivers mental health and substance abuse care.This Act has various effective dates, refer to Section 17 for the effective dates for each provision.

SB 630: Revise IVC Laws to Improve Behavioral Health
An act revising the laws pertaining to involuntary commitment in order to improve the delivery of behavioral health services in North Carolina. With a couple of exceptions laid out in Section 46, effective October 1, 2019 and applies to proceedings initiated on or after that date.

SB 750: Health-Local Confinement/Vet. Controlled Sub.
An act to address health issues in local confinement facilities and to ensure that state prisons are full participants in the NC Health Information Exchange known as NC HealthConnex, as recommended by the Joint Legislative Oversight Committee on Health and Human Services; to amend the duties of law enforcement officers pertaining to involuntary commitment; to amend the NC Controlled Substances Act and the Controlled Substances Reporting System pertaining to the practice of veterinary medicine; to require continuing education for veterinarians on abuse of controlled substances; to include the NC Veterinary Medical Board on the Prescription Drug Abuse Advisory Committee; and to amend various budget provisions. This Act has various effective dates, refer to Section 10 for the effective date for each provision.

Bills filed in 2018, but did not pass