GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1993

S	1 

SENATE BILL 199

Short Title:  GPAC/Carolina Access/Risk-Sharing.	(Public)
─────────────────────────────────────── 
Sponsors: Senators Martin of Guilford; Daniel and Blackmon.
─────────────────────────────────────── 
Referred to:  Government Performance Audit.
─────────────────────────────────────── 

February 17, 1993

A BILL TO BE ENTITLED
AN ACT TO IMPLEMENT A RECOMMENDATION OF THE GOVERNMENT PERFORMANCE AUDIT COMMITTEE TO EXPAND MEDICAID CAROLINA ACCESS STATEWIDE AND INTRODUCE ELEMENTS OF RISK-SHARING.
The General Assembly of North Carolina enacts:
Section 1.  The General Assembly finds that its recently implemented Carolina Access program, modeled after successful primary care case management programs of other states and currently serving 12 counties, effectively improves access to primary care services, encourages development of physician/patient relationships, and encourages appropriate utilization of all health care services.  The General Assembly finds that it is important to move quickly to phase in statewide implementation of the program so that it is available by July 1, 1994.  The General Assembly further finds that the additional administrative costs incurred in early statewide implementation will be more than offset by savings and that improved quality of care will also contribute to long-term savings, that access for Medicaid patients will be significantly enhanced, and that physicians and patients statewide will be introduced to coordinated care concepts.  The General Assembly further finds that the State should introduce risk-sharing into its Medicaid reimbursement system.
Sec. 2.  Effective July 1, 1994, the Division of Medical Assistance, Department of Human Resources, shall introduce elements of risk-sharing into its Medicaid reimbursement system.  These elements shall include at least one of the following:
(1)	A savings-sharing policy, in which primary care providers share in the savings that result from appropriate and cost-effective utilization of other health services, including physician specialty services, prescription drugs, and outpatient hospital services;
(2)	The capitation of payments for physician services to guarantee certain savings levels and for outpatient hospital services and prescription drugs to guarantee even greater savings.
Sec. 3.  Effective July 1, 1994, the Division of Medical Assistance, Department of Human Resources, shall have phased in Medicaid Carolina Access statewide.
Sec. 4.  There is appropriated from the General Fund to the Division of Medical Assistance, Department of Human Resources, the sum of twenty-five thousand dollars ($25,000) for the 1993-94 fiscal year and the sum of one million seven hundred ten thousand dollars ($1,710,000) for the 1994-95 fiscal year, to implement this act.
Sec. 5.  It is the intent of the General Assembly to appropriate additional funds to the Division of Medical Assistance, Department of Human Resources, in subsequent fiscal years, to implement this act, according to the following schedule:

Fiscal Year	Amount
1995-96	$1,900,000
1996-97	$2,000,000
1997-98	$2,000,000
1998-99	$2,100,000
1999-00	$2,200,000
2000-01	$2,300,000
2001-02	$2,400,000.
Sec. 6.  This act becomes effective July 1, 1993.