North Carolina SB 294: Reduce Maternal Morbidity/Mortality/Medicaid.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2023
S 1
SENATE BILL 294

Short Title: Reduce Maternal Morbidity/Mortality/Medicaid. (Public)
Sponsors: Senators Burgin, Chaudhuri, and Krawiec (Primary Sponsors).
Referred to: Rules and Operations of the Senate
March 13, 2023
*S294-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO REDUCE MATERNAL MORBIDITY AND MORTALITY THROUGH THE 2
IMPLEMENTATION OF RATE INCREASES FOR OBSTETRICS MATERNAL 3
BUNDLE PAYMENTS FOR PREGNANCY CARE AND ADDITIONAL MEDICAID 4
ADD-ON RATES AND COVERED SERVICES. 5
The General Assembly of North Carolina enacts: 6
SECTION 1.(a) The Department of Health and Human Services, Division of Health 7
Benefits (DHB), shall increase to at least seventy-one percent (71%) of the Medicare rate the 8
Medicaid rate paid for obstetrics maternal bundle payments for pregnancy care. This rate increase 9
shall be implemented as soon as practicable. 10
SECTION 1.(b) In order to incentivize the use of group prenatal care visits by 11
Medicaid beneficiaries, the Department of Health and Human Services, Division of Health 12
Benefits (DHB), shall develop an add-on rate to the relevant capitated rates or payments that 13
include prenatal care services. This add-on rate shall include amounts sufficient to make 14
payments to providers that achieve a level of Medicaid beneficiary participation in group prenatal 15
care visits. DHB shall determine the level of patient participation required for a provider to 16
receive these provider payments. These provider payments may be used by a provider to establish 17
incentives for Medicaid beneficiary patients to attend group prenatal care visits. This rate increase 18
shall be implemented as soon as practicable. 19
SECTION 1.(c) DHB shall seek approval from the Centers for Medicare and 20
Medicaid Services (CMS) to implement Medicaid coverage of certain healthcare services 21
provided by a doula. DHB shall develop the parameters of services to be covered, including 22
updating applicable clinical coverage policies, developing appropriate reimbursement for 23
covered services provided by a doula, and determining provider credentialing requirements for 24
participation in the NC Medicaid program. This coverage shall be implemented as soon as 25
practicable upon approval by CMS. DHB shall report to the Joint Legislative Oversight 26
Committee on Medicaid and NC Health Choice no later than March 1, 2024, regarding the details 27
of the Medicaid coverage of healthcare services provided by a doula, the specific reimbursement 28
for these services, and the estimated recurring cost to the State of providing this coverage. 29
SECTION 2. There is appropriated from the General Fund to the Department of 30
Health and Human Services, Division of Health Benefits, the sum of two million eight hundred 31
thousand dollars ($2,800,000) in recurring funds for each year of the 2023-2025 fiscal biennium 32
to implement the Medicaid-related changes outlined in this act. These funds shall provide a State 33
match for five million five hundred thousand dollars ($5,500,000) in recurring federal funds for 34
each year of the 2023-2025 fiscal biennium, and those federal funds are appropriated to the 35

General Assembly Of North Carolina Session 2023
Page 2 Senate Bill 294-First Edition
Division of Health Benefits to pay for costs associated with the Medicaid-related changes 1
outlined in this act. 2
SECTION 3. Section 2 of this act is effective July 1, 2023. The remainder of this act 3
is effective when it becomes law. 4