House passes long-term Medicaid plan

Posted by Lynn Bonner on July 2, 2014 

The N.C. House vision for long-range Medicaid changes received unanimous approval Wednesday.

The bill would have provider-led health care networks be responsible for most overruns in the Medicaid budget by 2020. The provider-networks would receive a set amount of money each year for medical services for the patients they treat, and the networks would have to eat the losses if they spend more. The House passed the bill 113-0 and sent it to the Senate for consideration.

“It’s requiring providers be accountable for the budget and program outcomes,” said Republican Rep. Nelson Dollar of Cary, the bill’s sponsor.

The proposal debuted two weeks ago in a House health committee. Between then and now, a controversial provision that would have engaged the regional mental health agency Cardinal Innovations in an experiment that placed it in charge of physical health care for some disabled people was removed.

The bill won endorsements from the N.C. Hospital Association, the N.C. Medical Society, and the association of regional mental health offices.

Requiring providers to take responsibility for overruns in Medicaid health costs moves the House closer to a position advocated by state Senate Republicans.

But Senate Republicans want an integration of physical, mental and dental health under Medicaid.

And the House would leave planning and execution to the state Department of Health and Human Services, while Senate Republicans want the state Medicaid office split from DHHS.

The Senate prescription for Medicaid is in its version of the budget.

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