Bill > S466

This bill aims to improve healthcare continuity and access for Medicaid beneficiaries in North Carolina's Behavioral Health and Intellectual/Developmental Disabilities (BH IDD) Tailored Plans. The bill requires the Department of Health and Human Services to submit an amendment to the state's 1115 Medicaid Transformation waiver to the Centers for Medicare and Medicaid Services (CMS) by July 1, 2025, with two key provisions: first, beneficiaries can choose to remain in the traditional Medicaid fee-for-service program (Medicaid Direct) for physical healthcare services if their current healthcare providers are not in the Tailored Plan network, ensuring continuity of care; second, beneficiaries may opt into a BH IDD Tailored Plan operating outside their residential region if the alternative plan offers better service arrays or provider networks. Additionally, by August 1, 2025, the Department must report to the Joint Legislative Oversight Committee on Medicaid with recommendations for promoting competition among local management entities/managed care organizations, with the goal of fostering innovation and improving care quality for Medicaid beneficiaries. The bill becomes effective immediately upon becoming law.

https://www.ncleg.gov/BillLookUp/2025/S466