Medicaid

The North Carolina Department of Health and Human Services says it's working to reduce the error rate in Medicaid payments to providers and hospitals.

A new report from State Auditor Beth Wood says North Carolina improperly spent $835 million last year.

A picture of a young man with his head in his hands.
Sander van der Wel / Wikipedia

More adults are coming under the legal authority of guardians. Many adults who are declared incompetent by a court have a relative who takes over guardianship. But for those who don't, the state takes over that role.

The North Carolina Department of Health and Human Services said in an e-mail that there were about 3,000 adults with public guardians in 2007. That number is expected to double by about 2017.

ICD-9 logo
http://icd9cm.drgily.com/ / Wikipedia

Doctors and hospitals will have a higher bar to clear when submitting insurance claims, starting today.

Federal law requires them to begin tracking patient care and submitting insurance claims using the more specific ICD-10 coding system. The broader ICD-9 had been in place for decades.

Julie Henry is a spokeswoman for the North Carolina Hospital Association.

Jorge Valencia / WUNC

Bill Would Ban The Sale Of Fetal Tissue From Abortions

Republicans in the Senate's rules committee cleared a bill on Wednesday  that would ban the sale of fetal tissue from abortions.

House Bill 297  is a reaction to a national controversy after an anti-abortion group’s undercover videos suggested Planned Parenthood was selling fetal tissue from abortions.  

The chambers of the NC State House
Jorge Valencia / WUNC

The North Carolina House and Senate approved on Tuesday afternoon a long-awaited plan to overhaul the state's Medicaid system. The proposal could affect more than 1.5 million people who receive health care through the publicly-funded program, but it could take years for it to be fully implemented.

Top Republicans celebrated on Tuesday as they passed a proposal they've been working on for four years. Medicaid serves about 1.8 million people who qualify as low-income or disabled, almost one fifth of the state population.

About 1.8 million people in North Carolina receive healthcare through Medicaid. The program provides for those who are low income and is funded by federal and state dollars.

A recent state audit found that the organization overseeing most Medicaid patients has saved taxpayers more than a billion dollars since 2002. Still, state lawmakers have been poised for years to overhaul the system, and it appears now that a deal is close.

A picture of a woman with a bathtub balance seat.
Richard Duncan / CDC

North Carolina's population is aging quickly, increasing the demand for personal caregivers. But a report from a poverty advocacy organization says elderly people might have trouble finding reliable care unless caregivers' wages increase.

The North Carolina legislative office building
Wikipedia

State lawmakers passed a temporary spending measure this week to keep North Carolina’s government running for 45 days.

The move allowed lawmakers to avoid the midnight deadline tonight that marks the end of the fiscal year. Legislators to continue to debate differences over tax structure, education spending and Medicaid. 

Host Frank Stasio talks with WUNC capitol reporter Jorge Valencia about the latest. 

A picture of a dctor holding a stethoscope.
Alex Proimos / Flickr

North Carolina lawmakers have chosen to not expand Medicaid eligibility under the Affordable Care Act.

Republican state leaders, including Senate Leader Phil Berger and House Speaker Tim Moore, have said that, even if the federal government initially subsidizes new people enrolling in Medicaid, the program would eventually cost the state more than it saves.

Medicaid illustration: A Caduceus symbol and a dollar sign
Neff Conner / Flickr

The North Carolina House of Representatives approved a plan Tuesday to allow non-profit groups of hospitals and doctors to manage care for most of the state’s 1.8 million Medicaid health recipients, formally setting the stage for a clash with the Senate over how to revamp the program.
 

The House plan, which lawmakers have discussed since at least 2011 when Republicans took over a majority in both chambers, would allow state health officials to pay the non-profits a predetermined amount of money for the medical care of each patient and would be phased in by as early as 2020.

Photo: The North Carolina seal in front of the state legislative building
Jorge Valencia

Lawmakers take up the state's budget with a month-end deadline looming. Senate leaders passed their plan this morning. It increases pay for new teachers but cuts back on teaching assistants. 

The $21 billion plan also puts Medicaid under the control of an outside agency. But the Senate plan differs greatly from the House proposal and the Governor's plan. Lawmakers need to reconcile the differences before June 30 or pass a continuing resolution to keep the government funded.

NC General Assembly; State Legislature.
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The North Carolina Senate gave preliminary approval on Wednesday afternoon to a two-year budget that would cut funding for thousands of public school teaching assistant positions, and would make significant policy changes to the state's tax code and Medicaid program.

The proposed $21.5 billion budget, which represents an almost 2 percent increase from the current year and was approved by Republicans along a party-line vote of 30-19, is scheduled for a final vote on Thursday.

N.C. General Assembly, State Legislature
Dave DeWitt / WUNC

State Senate leaders held a news conference Monday to discuss details of their $21.47 billion budget proposal. The proposal is smaller than the state House’s budget plan released almost a month ago, and  would create a separate state agency to administer North Carolina’s Medicaid program.

WUNC Capitol Reporter Jorge Valencia said the Senate has only given a general idea of its budget proposal, and includes increasing the starting salary pay for teachers to $35,000 a year, a $2,000 increase.

Medicaid illustration: A Caduceus symbol and a dollar sign
Neff Conner / Flickr

A North Carolina House committee has approved a plan to remake the state’s costly Medicaid program by allowing hospitals and physicians to manage the money spent to care for each patient.

The plan, which would shift much of the financial risk of growing Medicaid costs to provider-led entities, was approved after more than two hours of heated debate in the House of Representatives health committee. The bill is expected to be scheduled for a hearing in the appropriations committee on Thursday morning.

Image of tools in doctor's office
Morgan / Flickr/Creative Commons

The Affordable Care Act is still attracting big enrollment numbers in North Carolina.

Nearly 500,000 people in the state have coverage, but premiums could rise by as much as 40 percent next year for some health plans.

   

And the Obama administration says more than 300,000 people still are not covered because the state did not expand Medicaid. 

Medicaid reform is at the forefront of the state's legislative agenda this session, but legislators are still debating how to design the reform. 

The Senate wants to privatize administration and let commercial insurance companies control the market while the House and Governor McCrory want state health care providers to be in charge. A new report from Wake Forest University argues for a hybrid strategy.

Illustration: Cadeceus
Flickr user takomabibelot

North Carolina lawmakers got the first granular look at the state’s Medicaid program in 20 years, showing the program’s improving financial condition but continuing major debts to medical providers.

The audit found the Medicaid fund balance was $350 million in the red for the fiscal year ended June 30, 2014—almost $59 million better than a year earlier.
 

Illustration: Cadeceus
Flickr user takomabibelot

Roughly 480,000 people in North Carolina have signed up or been automatically re-enrolled for Obamacare plans by the end of January using the healthcare.gov system, according to government data released Friday. Almost 7.5 million in total have signed up across the country.

N.C. Attorney General Roy Cooper
N.C. Democratic Party

Attorney General Roy Cooper says he'll continue to criticize Republican policies during the legislative session that begins Wednesday, hinting once again hinting that he might run for governor in 2016.  
 

At a luncheon held by the women’s group Lillian's List, Cooper told a few hundred Democrats that he supports issues such as abortion rights and expanding Medicaid in North Carolina.

He hasn't announced his candidacy for governor, but he’s widely seen as the most likely Democrat to try to unseat Republican Gov. Pat McCrory.

Tulane Publications via Flickr/Creative Commons

A legislative subcommittee has endorsed a measure that would take oversight of the state's Medicaid program away from the Department of Health and Human Services.

The subcommittee approved the measure Thursday.
 

It would place an eight-member board in charge of the state's Medicaid program. The group would run Medicaid with a set amount of funds, given by the legislature every year. That means it would have the power to increase or reduce services for patients.

The head of Blue Cross and Blue Shield of North Carolina is speaking out in support of expanding Medicaid in the state.

Brad Wilson is President and CEO of Blue Cross and Blue Shield of North Carolina.

“As business leaders of North Carolina, you need to help us craft a solution to expand Medicaid," said Wilson.

Wilson tossed out that charge during this week’s Economic Forecast Forum in Research Triangle Park, sponsored by the North Carolina Bankers Association and the North Carolina Chamber of Commerce. 

Ralf Heb / Flickr/Creative Commons

In recent months, Governor Pat McCrory has said he’s considering proposing expansion of the state’s Medicaid program, which would allow more low-income people here to receive health care. Back in 2012, the General Assembly passed a bill blocking expansion and the formation of a state health exchange. The governor signed it into law. But now, many other Republican-led states are moving forward with enlarging eligibility for the program. Yet Republican leaders don’t have a consensus on what to do here.

A picture of a stethoscope.
jasleen_kaur / Flickr/Creative Commons

A Medicaid oversight subcommittee has approved recommendations laying out goals for reform of the state's health insurance program for low-income residents. But support for the measure was not unanimous among Republicans. 

The recommendations approved Tuesday will now go before the full Health and Human Services oversight committee.

Two-pages of findings sketch out general goals for Medicaid reform in the state. Overall, it reiterates the feeling among some lawmakers- including Senator Ralph Hise- that the primary goal in reforming Medicaid should be to cut costs.

Pat McCrory
Dave DeWitt

Governor Pat McCrory has filed a suit against House Speaker Thom Tillis and Senate Leader Phil Berger, saying he's trying to stop them from usurping executive powers.

The lawsuit, filed in Wake County Superior Court, alleges violations of the separation of powers, executive power, and appointments provisions of the state Constitution, the Raleigh News & Observer reported. Former governors Jim Hunt, a Democrat, and Jim Martin, a Republican, joined McCrory in the filing.

Image of tools in doctor's office
Morgan / Flickr/Creative Commons

State health secretary Aldona Wos says North Carolina would likely need to change some of its Medicaid rules to expand the program under the Affordable Care Act. 

The health care law offered to pay for expanded Medicaid through 2016, but North Carolina was one of 24 states that rejected the expansion last year.  Gov. Pat McCrory said the state's Medicaid program was broken, and was not confident the federal government would cover the costs. 

But Wos says Medicaid is now more stable, and she plans to present the governor with options for expanding Medicaid. 

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