North Carolina Pulse Report

Sate Capitol building in Raleigh, NC. USA

North Carolina’s long-debated budget plan was finally approved and sent to the desk of Gov. Roy Cooper, who plans to let it become law without his signature. The budget, which held up the adjournment of this year’s legislative session, allocates $29.8B for 2023-24 and $30.9B for 2024-25. It will increase the state’s rainy-day fund balance by $125 million, bringing it to just under $5 billion.

The budget includes Medicaid expansion – supported by $1.6 billion in nonrecurring federal funds – and funding for several other bills affecting hospitals. The Centers for Medicare and Medicaid Services (CMS) is expected to approve the state’s expanded Medicaid program, benefiting those with incomes below 133% of the federal poverty level.

The Healthcare Access and Stabilization Program (HASP) has been approved by CMS. Through HASP, North Carolina’s hospitals and health systems could obtain up to $1.8 billion in federal funding to enhance Medicaid patients’ access to care.

Other significant healthcare budget items include $7.33 billion to fund the state’s Health and Human Services Department. Of those funds, $50 million in one-time funding will be set aside for healthcare service providers in rural and underserved areas, and an additional $80 million will be designated to assist families caring for children with behavioral health issues and special needs.

The budget also funds increased reimbursement rates for skilled nursing facilities, personal care services, and Medicaid behavioral health providers.

Another pivotal healthcare development occurred when lawmakers sent HB 125, the NC Health and Human Service Workforce Act, to Gov. Cooper for consideration. This bill aims to safeguard healthcare workers from violence by mandating that certain hospitals place law enforcement officers in emergency departments. It also proposes greater penalties for those who assault specific medical personnel.

Notably absent from the budget were provisions granting antitrust exemptions to university-based UNC Health and ECU Health, and any references to casinos.

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