Bill > S699

This bill directs 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 individuals in adult care homes with incomes slightly above current Special Assistance Program limits. Specifically, the bill seeks to provide Medicaid coverage for people with incomes up to 180% of the federal poverty level (for those who would qualify for basic rate assistance) or up to 200% of the federal poverty level (for those who would qualify for enhanced rate assistance). The request must ensure that any new Medicaid coverage is cost-neutral by generating offsetting savings or cost avoidances and must comply with all legal requirements. DHB is required to submit this request to CMS within 90 days of the law taking effect and can only implement the expanded coverage if CMS approves the request and it meets all the specified goals. The bill aims to increase access to Medicaid services for dual-eligible individuals and provide alternatives to nursing home placements.

https://www.ncleg.gov/BillLookUp/2025/S699