Medicaid reform

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.

NC General Assembly
Jorge Valencia

Republican leaders in the state house and senate have finally reached an agreement on at least part of the state budget.

They have made a deal that sets the budget at $21.735 billion. They still need to iron out agreements on state employee raises and funding for teaching assistants.

  Host Frank Stasio talks with WUNC Capitol bureau chief Jeff Tiberii about the latest.

North Carolina legislative building
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 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.

North Carolina is now tracking babies born with alcohol or drug dependencies.
Tulane Publications / 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.

North Carolina is now tracking babies born with alcohol or drug dependencies.
Tulane Publications / Flickr, Creative Commons

An effort to open the state’s Medicaid program to managed care ran into trouble today. A report that passed a subcommittee easily last week was gutted in a health and human services oversight committee meeting this morning.

The move may indicate a victory for the administration and some Republicans who want to build on an existing program for Medicaid patients. 

This morning, Health and Human Services Secretary Aldona Wos left no doubt where she stands on the issue of Medicaid reform. She addressed a conference room filled with state lawmakers, reporters, and lobbyists.

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. 

Aldona Vos, DHHS
North Carolina Department of Health and Human Services

    

North Carolina’s Medicaid program covers 1.7 million people at a cost of $14 billion per year.

The program for low-income and disabled residents has had a turbulent past. Last year, computer glitches created a long backlog of applications and payments for providers. And Medicaid has been a question mark in the budget, causing cost overruns for several years.

But health officials say the system is improving enough that the state could reconsider expanding Medicaid to half a million people who do not have health insurance.

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

North Carolina health officials say the state Medicaid program has a positive cash balance for the first time in years.

For years, the state health insurance for people who are poor or disabled has cost tax payers more than expected. We're talking hundreds of millions of dollars.

But that wasn't the case last year. Aldona Wos, the state secretary for Health and Human Services, says the Medicaid budget was in the black.

photo of the North Carolina Senate
Government & Heritage Library, State Library of NC / Flickr

  After a prolonged legislative session marked by delayed talks and Republican infighting, the General Assembly has finished its work and adjourned for the year.

The short session dragged on as lawmakers struggled to compromise over key issues, including teacher pay and coal ash. Legislators managed to strike a last-minute deal on Wednesday that would work to remove coal ash from 33 ponds across the state.

NC Legislative building
NC General Assembly

Lawmakers in the state Senate have tentatively approved a bill that would overhaul North Carolina's Medicaid system. The measure would create an independent agency to oversee the state's health care system for low-income residents. The bill would also contract out Medicaid to managed care and provider-led organizations. They would receive a set amount of money per patient to provide care. Republican Senator Ralph Hise is a sponsor of the bill. He says it's necessary to help control ballooning Medicaid costs.

NC Legislative building
NC General Assembly

A measure put forth by the state Senate to overhaul North Carolina's Medicaid program is headed for a vote in the chamber next week.

The proposal would allow both provider-led and managed care plans to serve patients who qualify for the health insurance program.

Senate leaders say their plan would help control costs. It would also create an entirely new department to oversee Medicaid in the state, headed by a corporate-like board. Republican Senator Louis Pate is a sponsor of the measure.

NC Legislative building
NC General Assembly

  

Despite sluggish negotiations over the past two weeks, state lawmakers are taking small steps toward a budget deal. 

The House and Senate are working on compromises for teacher raises and Medicaid spending. They are also considering ways to reform the Medicaid system, including treatment from managed care organizations. 

Meanwhile, lawmakers passed a bill to review and possibly replace Common Core standards.

Randall Williams

  

North Carolina native Randall Williams says he knew he was going to be a doctor when he was four years old.

Unlike many who think they know their career path, Williams never changed his mind. He started working in the emergency room of his hometown hospital in Burlington as a teenager. He served as everything from a candy striper to an orderly before going to medical school.

He is now a Raleigh physician who has taken 11 trips to Iraq, Afghanistan, Libya and Palestine for medical missions. He ran for mayor of Raleigh in the latest election.

The state’s Medicaid Reform Advisory Committee is comprised by Sen. Louis Pate, Dr. Richard Gilbert, Dennis Barry, Peggy Terhune and Rep. Nelson Dollar
Jorge Valencia

A committee in the state House of Representatives is recommending a plan to reform Medicaid insurance for people who are poor or disabled.

The proposal says a majority of Medicaid patients would be treated by providers who receive a fixed amount of money per patient.

The governor’s office shows support for the bill. Health and Human Services Secretary Aldona Wos praised it in a committee hearing Thursday.

"We are very pleased with the House bill that it closely aligns with Gov. McCrory's medicaid reform plan," Wos said.

Governor Pat McCrory held a news conference yesterday at the executive mansion to talk about one thing in particular he doesn’t like in the Senate budget proposal- turning Medicaid services over to a managed care organization. The governor, the Secretary of Health and Human Services, hospital organizations and physicians are against the idea.

Governor McCrory held the news conference in a secluded garden at the executive mansion. Dozens of doctors wearing their long white coats gathered on the brick steps behind him.