A BILL TO BE ENTITLED
AN ACT to provide for A 90‑day retroactive period for prior approvals for personal care services as part of the north carolina Medicaid program.
The General Assembly of North Carolina enacts:
SECTION 1.  The Department of Health and Human Services, Division of Medical Assistance, shall amend Section 5.5, Retroactive Prior Approval for PCS, of Clinical Coverage Policy 3L, State Plan Personal Care Services (PCS), to extend the allowable retroactive period for prior approvals for personal care services from 10 days to 90 days upon the same conditions that are currently required for retroactive prior approval of personal care services. This section shall not be construed to require Medicaid reimbursement for personal care services provided within the retroactive period in excess of the number of hours approved through the prior approval process. Consistent with authority granted to the Department of Health and Human Services (DHHS) under G.S. 108A‑54(e), DHHS shall not be required to maintain this policy change after June 30, 2019.
SECTION 2.  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Medical Assistance (DMA), the sum of four million eight hundred ninety‑seven thousand dollars ($4,897,000) in recurring funds for the 2017‑2018 fiscal year and the sum of five million one hundred fifty‑seven thousand dollars ($5,157,000) in recurring funds for the 2018‑2019 fiscal year. These funds shall provide a State match for an estimated ten million two hundred twenty‑two thousand dollars ($10,222,000) in federal funds for the 2017‑2018 fiscal year and ten million seven hundred sixty‑four thousand dollars ($10,764,000) in federal funds for the 2018‑2019 fiscal year, and those federal funds are hereby appropriated. During the 2017‑2019 fiscal biennium, DMA shall utilize funds appropriated in this section to implement the 90‑day retroactive prior approval period for personal care services required by Section 1 of this act.
SECTION 3.  This act becomes effective July 1, 2017, and applies to Requests for Independent Assessment for Personal Care Services Attestation for Medical Need forms received on or after that date.