Post-Session Bill Summaries - Healthcare Related Legislation

Although some bills remain on the Governor's desk, we figured it was time to start sharing some of our legislative summaries from the 2013 long session.  We will be posting these by subject matter over the next few days.  Please let us know if you have any questions.

Legislation Related to Healthcare, including Medicaid

HB 5, Temporary Funding/Group Homes and Special Care Units (Dollar, Burr).  HB 5 allowed individuals in group homes who are no longer eligible for Personal Care Services due to the change in law and individuals in Special Care Units who have reduced Personal Care Services due to the change in law to access the $39.7 mil allocated in last year’s budget for residents of Adult Care Homes who lost Personal Care Services due to the eligibility changes.  The bill was signed into law on March 6 and is S.L. 2013-4.  It was effective when it became law and expired on June 30, 2013.

HB 70, North Carolina Health Plan (Brandon).  HB 70 proposed a state Health Plan to cover all state residents with comprehensive health benefit coverage, as an alternative to a Health Benefit Exchange.  It was never heard in committee.

HB 99, Caregiver Relief Act (Adams, Hall)/SB 535 (Kinnaird, Parmon, Bryant).  The Caregiver Relief Act would extend protections and leave under the Family Medical and Leave Act to eligible employees to care for a sibling, grandparent, grandchild, stepparent, or parent‑in‑law.  The bill was not heard by either chamber.

HB 100, Healthy Family & Workplaces/Paid Sick Days (Adams, Hall)/SB 536 (Kinnaird, Parmon, Bryant).  This legislation would provide for paid sick days for all employees. The bill was not heard by either chamber.

HB 109, Require Safety Helmets/Under 21 (Torbett, Speciale).  HB 109 was amended in the House Judiciary B subcommittee to direct the Joint Legislative Transportation Oversight Committee to review the laws of North Carolina and other states relating to the use of motorcycle helmets, and consider whether the State's motor vehicle laws should be amended to provide exceptions to the requirement that all operators and passengers on motorcycles or mopeds wear a safety helmet.  It was approved by the full House.

HB 130, Mental Health Workers' Bill of Rights (Bell). HB 130 seeks to enact an Article 8 in Chapter 122C to establish a bill of rights for mental health workers.  It was never heard in committee.

HB 247, Freedom to Negotiate Health Care Rates (Burr, Starnes, Avila, McElraft).  HB 247 allows health providers and insurers to negotiate reimbursement rates and prohibits contract provisions that restrict rate negotiations.  It was signed by the Governor on May 8, 2013 and is S.L. 2013-234. 

HB 256, VA Survivors Benefits/Medicaid Eligibility (Farmer-Butterfield, Glazier, Lewis).  HB 256 will allow a deduction for Veterans Affairs survivors pension benefits when defining income for Medicaid eligibility.  It received a favorable report from the House Military and Homeland Security committee but was never heard in the House Health and Human Services committee.

HB 308, Funds/MHDDSA Services/Non-Medicaid Eligibles (Insko, Earle).  HB 308 seeks to allocate $78 mil for MH/DD/SA services specifically for individuals who are not eligible for Medicaid.  It was referred to the House Appropriations committee but was never heard or incorporated into the budget.

HB 344, Uniform MH Reporting Requirements For NICS (Insko, Glazier, Luebke, Foushee).  HB 344 seeks to amend  G.S. 122C‑54(d1) regarding transmission of involuntary commitment data to the National Instant Criminal Background Check System to mandate the transmittal of involuntary commitment data, as well as other judicial determinations, to the NICS within 48 hours.  It was referred to the House Rules committee and never heard.

HB 399, Amend Laws Pertaining to DHHS (Agency Bill) (Burr, Hollo, Avila).  HB 399 seeks to make changes requested by DHHS to laws Pertaining to Child Abuse, Neglect, and Dependency; Medicaid; and Public Health, including payment of Medicaid expenses from a recipient’s estate; and additional Medicaid providers in the limited and moderate risk categories.  It was signed by the Governor on July 29, 2013 and is S.L. 2013-378.

HB 459, Chronic Care Coordination Act (Dollar, Murry, Hollo, Lambeth).  HB 459 requires the DHHS Divisions of Public Health and Medical Assistance, and the Division in the Department of State Treasurer responsible for the State Health Plan to collaborate to reduce the incidence of chronic disease and improve chronic care coordination within the State.  It was signed into law on June 26, 2013 and is S.L. 2013-207.

HB 492, Safeguard Qualified Individuals/Medicaid PCS (Dollar). HB 492 allows for an additional 50 hours per month of Medicaid Personal Care Services (“PCS”) for recipients who meet the PCS eligibility criteria and additional criteria, with the condition that rates will be reduced to allow for the additional hours within the current Medicaid budget.  It also directs the department to submit a State Plan Amendment by August 15, with an effective date of July 1. It was signed into law on July 18, 2013 and is S.L. 2013-306.

HB 498, Mandate Autism Health Insurance Coverage (McGrady, Murry, Cotham, Shepard).  The bill requires health benefit plans, including the State Health Plan, to provide coverage for the treatment of Autism Spectrum disorders.  The bill includes a $36,000 cap, an age limit up to 23, and to benefit the insured must be diagnosed by the age of 8.  The bill was approved by the full House but has not been heard in the Senate.  It is eligible to be heard in the short session.

HB 543, Guardianship Roles of MH/DD/SA Providers (Jones, Avila, Glazier, Turner). HB 543 amends the guardianship statute to prohibit corporations from being appointed as guardian for any individual to whom it provides MH/DD/SA services for compensation as part of a contractual or other arrangement with an LME; and to prohibit any individual who contracts or is employed by an entity that contracts with an LME from serving as a guardian for a ward for whom the individual or entity is providing these services, unless the individual is one of the following:  a parent of that ward; a member of the ward's immediate family; a licensed family foster care provider; or a licensed therapeutic foster care provider who is under contract with an LME.  The bill also directs the HHS Oversight Committee to appoint a subcommittee to examine the impact of the 1915(b)/(c) Medicaid Waiver and other mental health system reforms on public guardianship services, including guardianship roles, responsibilities, and procedures and the effect on existing relationships between guardians and wards, with findings to be reported on or before May 9, 2014.  The bill was signed by the Governor on July 10, 2013 and is S.L. 2013-58.

HB 601, Opt Out of Statewide Medicaid Transportation System (Jones, Holloway).  This bill will allow counties to opt out of the statewide non-emergency Medicaid transportation system for Medicaid recipients, which was directed in last year’s budget.  It was never heard in committee.

HB 605, Establish Aging Subcommittee/HHS Oversight (Dollar, Burr, Hurley, Farmer-Butterfield).  HB 605 directs the HHS Oversight Committee to appoint a Subcommittee on Aging to examine the State's delivery of services for older persons in order to determine their service needs and make recommendations to the HHS Oversight Committee on how to address their service needs.  The bill was approved by the House but did not proceed in the Senate.

HB 625, Zoning/Health Care Structure (Moffitt, Howard, Setzer, Ramsey). HB 625 is very similar to a bill filed last session.  It will allow a ”temporary family health care structure” to be used by a caregiver in providing care for a “mentally or physically impaired person” on property owned or occupied by the caregiver as the caregiver's residence as a permitted accessory use in any single family residential zoning district on lots zoned for single family detached dwellings. It was approved by the full House and the Senate State and Local Government committee but did not make it through the full Senate.  It is eligible for consideration in the short session.

HB 635, Involuntary Commitment Custody Orders (Lambeth, Conrad, Terry, Hanes). HB 635 will allow the clerk or magistrate to issue an order by fax or an electronically scanned order by electronic transmission to a physician or eligible psychologist at a 24 hour facility to take a respondent into custody at the 24 hour facility.  It also directs the HHS Secretary to review and update its list of facilities designated under G.S. 122C-252 as facilities for the custody and treatment of involuntary clients. The Secretary shall ensure that each designation identifies the specific units or areas of the 24-hour facility to which the designation applies and includes all units or areas necessary to facilitate the orderly and safe movement of a respondent from one unit or area to another.  It was signed by the Governor on July 18 and is S.L. 2013-308.  It becomes effective October 1, 2013.

HB 638, Increase Membership of Area Boards (Steinberg, Tine).  HB 638 seeks to amend 122C-118.1 regarding the size of an area authority (LME/MCO) board to allow a multicounty area authority with 10 or more constituent counties, to have no fewer than 11 and no more than 30 voting members (the law now is 11-21).  It was never heard in committee.

HB 674, Study Medicaid Provider Hearings (Stevens).  HB 674 directs the Program Evaluation Oversight Committee to Direct the Program Evaluation Division to study the contested case process for Medicaid provider appeals.  It was approved by the full House but was not taken up in the Senate.  It was included in the study bill that was approved by the House Rules committee, but the study bill was never taken up by the full House.

HB 693, Eliminate Exceptions/Med Treatment/Minors (Whitmire, Fulghum, Brisson, Schaffer).  HB 693 proposed an elimination of exceptions for parental consent for medical treatment for minors seeking treatments for mental health, substance abuse, sexually transmitted diseases and pregnancy.  After facing vigorous opposition, the bill was pulled from the House floor and re-referred to the House Judiciary committee.

HB 798, Release of Medical Records (D. Hall, Moffitt, Murry, Baskerville).  HB 798 defines medical records, financial records and personal representative; provides a timeline for a provider to respond to a request for medical records; and a fine for each day a provider does not comply.  It was never heard in committee.

HB 831, Educational Services for Children in PRTFs (Avila, Johnson, Glazier). HB 831 seeks to allocate funds to PRTFs for educational services. The bill was approved by the full House in the last days of the session but was not taken up by the Senate.  It is eligible for the short session.

HB 834, Modern State Human Resources Management/RTR (Collins, Burr). HB 834 makes several changes to state human resources management: changes to the State Personnel Commission, increases the number of exempt positions in state government, and amends the grievance and appeal procedures. It also enacts the Reorganization Through Reduction Program (RTR).  The bill also seeks to make changes to state statute to improve transparency in the cost of health care provided by hospitals and ambulatory surgical facilities; to provide for fair health care facility billing and collection practices; and to provide that hospitals receiving Medicaid reimbursements participate in the NC Health Information Exchange.  As of the date of this report, it has been submitted to the Governor but has not yet been signed.

HB 867, Medicaid County of Residence (Avila, Burr, Hollo, Brisson). HB 867 exempts recipients of services under 1915(b)/(c) managed care waivers from Medicaid home origin requirements.  Medicaid recipients served pursuant to the State's Section 1915(b)/(c) managed care wavier shall be based on the individual's Medicaid current county of residence, and Innovations waiver slots shall be portable.  It was approved by the full House but not taken up in the Senate.  It is eligible for the short session.

HB 877, Navigator Training and Certification (Collins, S. Ross, Tine).  The bill provides for certification of Heath Insurance Navigators.  The bill was approved by the House Insurance committee but did not proceed further.

HB 900, Exempt Continuing Care Facilities from CON (Avila, Samuelson, Burr, Setzer).  HB 900 seeks to exempt Continuing Care Retirement Communities from Certificate of Need review for communities that provide home health services to individuals receiving lodging within those communities.  The bill was approved by the House Health and Human but was pulled before a full House vote and referred to the House Rules committee.  Because the bill was not passed before the cross-over deadline, the matter will likely not proceed.

HB 909, Study/Increase Assisted Living in Rural Areas (Tine, Collins, G. Graham, Whitmire).  HB 909 directs DHHS to study strategies for increasing Assisted Living facilities in rural areas of the state, including exempting adult care homes that serve only elderly persons from Certificate of Need review.  The bill was never heard in committee but was included in the House study bill that was approved by the House Rules committee but did not proceed through the House.

HB 981, New MHDDSA Region & Psych Hospital (Burr, Howard, McNeill, Carney).  HB 981 directed the MH/DD/SAS Commission to designate an additional region in south central North Carolina for the services that would include at least Anson, Cabarrus, Davidson, Davie, Forsyth, Mecklenburg, Montgomery, Moore, Randolph, Richmond, Rowan, Scotland, Stanly, and Union counties.  It also sought funding for a new 200-bed State psychiatric hospital to provide acute psychiatric treatment services to individuals residing within the new region.  The bill was never heard in committee and was not included in the budget.

HB 982, Modify Medicaid Subrogation Statute (Burr, Avila). HB 982 seeks to modify the state statute regarding recovery of health care expenditures made on behalf of Medicaid beneficiaries who are tort victims in response to the US Supreme court decision, Wos v. E.M.A. It was signed by the Governor on July 18 and is S.L. 2013-274.

SB 83, Encourage Vounteer Care in Free Clinics (Bingham).  SB 83 seeks to encourage volunteer health care in free clinics by limiting the liability of medical and health care providers if the free clinic provides patients with a specified notice of limited liability. It was signed by the Governor on May 13, 2013 and is S.L. 2013-49.

SB 137, Prohibit Waiver Co-Pay/Medicaid Providers (Tillman). SB 137, as originally filed, sought to amend NCGS 108A-63 to make it unlawful for any provider of medical assistance to waive the collection of co-payments with the intent to induce recipients to purchase, lease, or order items or services from the provider, or in return for referrals or in return for purchasing, leasing, ordering, or arranging for a good, facility or service.  The bill was amended to only apply to pharmacies.  The bill was signed into law on June 19, 2013 and is S.L. 2013-145.

SB 208, Effective Operation of 1915(b)/(c) Waiver (Tucker, Barringer). SB 208 seeks to define LME/MCOs in state statute and enact parameters for a properly functioning LME/MCO. If an LME/MCO cannot operate in accordance with the law, the HHS Secretary shall transfer the operation of that LME/MCO to another LME/MCO.  It was signed into law by the Governor on June 12 and is Session Law 2013-85.

SB 223, Severance and Relocation for Area Directors (Hise).  SB 223 amends state statute to allow an area board of an LME to offer severance and relocation benefits to recruit an area director.  It has been approved by the full Senate and referred to the House Government committee.  It was signed by the Governor July 23, 2013 and is  S.L. 2013-339.

SB 334, Dorothea Dix Lease (Hise, Pate, Tucker)/HB 319 (Burr, Avila, Cleveland, Hurley).  This legislation was filed in response to the lease of the Dix property in the last days of the Perdue administration. The bill sought to take by condemnation the leasehold interest in the Dix property that was conveyed to the City of Raleigh.  It further specified that any proceeds from sale or lease of the property shall be used solely for mental health treatment purposes. The Senate and the House took two different approaches to voiding the lease, and the bill ended in a conference committee.  In the meantime, discussions continued between the Governor and the city of Raleigh on a compromise that would satisfy all parties.

SB 336, Collaboration among State Diabetes Programs (Pate).  SB 336 requires the Divisions of Medical Assistance and Public Health and the State Health Plan Division within the Department of the State Treasurer, to coordinate the diabetes programs they each administer, including the development of plans to reduce the incidence of diabetes, to improve care, and to control complications.  It was signed by the Governor on June 26, 2013 and is S.L. 2013-192.

SB 473, Health Cost Transparency/Speaker and PPT Standing (Rucho, Brown).  In its final form, SB 473 made further adjustments to the law regarding health care cost reductions and transparency, as passed in HB 834 (discussed above).  Language was also added to the bill in its last stages to allow legislative leadership, as agents of the state, to jointly intervene on behalf of the General Assembly in any judicial proceeding challenging a North Carolina statute or a provision of the North Carolina Constitution.  As of the date of this report, the bill had been presented to the Governor but was not yet signed.

SB 553, LME/MCO Enrollee Grievances and Appeals (Hise).  SB 553 creates a new chapter to govern LME/MCO recipient appeals.  The Senate version of the bill incorporated a number of procedures and standards from the current governing statute, including mediation, burden of proof and notice requirements.  Unfortunately, the House version made significant changes to the bill and the notice requirements were not incorporated into the final version of the bill.  The final version also shifts the burden of proof in every appeal to the recipient.  However, the recommendations of the Blue Ribbon Commission to set up the Supportive Housing Program and the Community Living Housing Fund were incorporated into the bill and will be in statute.  As of the date of this report, the legislation has been presented to the Governor but was not yet signed.

SB 556, Wind Up High Risk Health Insurance Pool (Hise).  SB 556 provides for the dissolution of the high risk insurance pool as of January 1, 2014.  It was never enacted but provisions were included in HB 92, Technical Corrections.

SB 596, Establish Study Commission on TBI Services (Pate).  The bill was referred to the Senate Rules committee but never taken up.

SB 663, Blue Ribbon Commission Recs/Supportive MH Housing (Hise). SB 663 would implement the recommendations of the Housing Subcommittee of the Blue Ribbon Commission on Transitions to Community Living to require DHHS to establish a Supportive Housing Program and an Assistive Technology Reutilization Program and to create a Transitions to Community Living Housing Budget within the Transitions to Community Living Fund to integrate individuals with Mental Illness into Community-Based Supported Housing.  SB 663 was never taken up in the House but the portions related to the Supportive Housing Program and the Transitions to Community Living Fund were incorporated into SB 553.