Bill > H485

This bill requires the North Carolina Department of Health and Human Services' Division of Health Benefits (DHB) to submit a request to the Centers for Medicare and Medicaid Services (CMS) to expand Medicaid personal care services (PCS) coverage for certain individuals living in adult care homes. The proposed expansion would help people whose income is slightly above current Special Assistance Program limits, specifically those with incomes up to 180% of the federal poverty level (for basic rate qualification) or 200% of the federal poverty level (for enhanced rate qualification). The request must ensure that any new Medicaid coverage is cost-neutral by offsetting expenses through savings or cost avoidance, and must comply with all legal requirements. DHB must submit the request to CMS within 90 days of the law taking effect and will only implement the expanded coverage if CMS approves the request and it meets all specified goals. The primary aim of this legislation is to increase access to Medicaid services for dual-eligible individuals and provide alternatives to nursing home placements.

Government Affairs, Health and Social Services, Justice

https://www.ncleg.gov/BillLookUp/2025/H485