AN ACT to require team‑based care coordination in medicaid substance use treatment and to modify the medicaid program to suspend rather than terminate medicaid eligibility for incarcerated individuals.

The General Assembly of North Carolina enacts:

SECTION 1.(a)  The Department of Health and Human Services, Division of Health Benefits (DHB), is directed, in coordination with a working group of stakeholders established by DHB, to develop a team‑based care coordination Medicaid service that includes, at a minimum, screening for alcohol use disorder, opioid use disorder, and other mild to moderate substance use disorders; prescription medications for opioid use disorder and alcohol use disorder; recovery support; and case management.

SECTION 1.(b)  No later than October 1, 2025, the Department of Health and Human Services, Division of Health Benefits, shall submit a report to the Joint Legislative Oversight Committee on Medicaid and the Fiscal Research Division containing details on the new Medicaid service developed in accordance with this section. The report shall include all of the following:

(1)        The State share of the cost of the service.

(2)        The intended start date for the coverage of the service.

(3)        The types of PHP capitated contracts that will cover the service and any related proposed statutory changes to Article 4 of Chapter 108D of the General Statutes.

SECTION 1.(c)  The Department of Health and Human Services, Division of Health Benefits, is directed to develop a statewide campaign to (i) educate healthcare providers and community leaders about any changes made to the Medicaid program related to the treatment of alcohol use disorder, opioid use disorder, and other mild to moderate substance use disorders, (ii) train interested providers in clinical care for alcohol use disorder, opioid use disorder, and other mild to moderate substance use disorders, and (iii) encourage substance use disorder provider participation in the Medicaid program.

SECTION 2.  As required by the federal Consolidated Appropriations Act, 2024, P.L. 118‑42, the Department of Health and Human Services, Division of Health Benefits, shall update relevant Medicaid policy and, as necessary, the Medicaid State Plan to suspend, rather than terminate, Medicaid coverage upon a Medicaid recipient's incarceration. To facilitate implementation of the updated policy before the required federal deadline and potentially as early as July 1, 2025, the North Carolina Department of Health and Human Services and the North Carolina Department of Adult Correction shall enter into a memorandum of understanding to share data concerning the Medicaid eligibility status of individuals entering confinement at or released from North Carolina jails. The Department of Adult Correction is further directed to update its internal and external policies and manuals to reflect any changes necessary for implementation of the updated policy in compliance with federal law.

SECTION 3.  This act is effective when it becomes law.