North Carolina HB 491: NC SYMPHONY FUNDS

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 2
HOUSE BILL 491
Committee Substitute Favorable 10/21/25

Short Title: Medicaid Rebase Funding. (Public)
Sponsors:
Referred to:
March 25, 2025
*H491-v-2*
A BILL TO BE ENTITLED 1
AN ACT TO FUND THE MEDICAID REBASE. 2
The General Assembly of North Carolina enacts: 3
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MEDICAID REBASE FUNDING 5
SECTION 1. Notwithstanding the limitations under G.S. 143C-4-11 on the use, 6
allocation, and expenditure of funds reserved in the Medicaid Contingency Reserve, there is 7
appropriated from the Medicaid Contingency Reserve to the Department of Health and Human 8
Services, Division of Health Benefits, the sum of one hundred ninety million dollars 9
($190,000,000) in nonrecurring funds and associated receipts for the 2025-2026 fiscal year to be 10
used to adjust Medicaid funding to account for projected changes in enrollment, enrollment mix, 11
service and capitation costs, and federal match rates, as well as the implementation of the 12
Children and Families Specialty Plan in December 2025. 13
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LME/MCO INTERGOVERNMENTAL TRANSFERS 15
SECTION 2.(a) The local management entities/managed care organizations 16
(LME/MCOs) shall make intergovernmental transfers to the Department of Health and Human 17
Services, Division of Health Benefits (DHB), in an aggregate amount of eighteen million 18
twenty-eight thousand two hundred seventeen dollars ($18,028,217) in the 2025-2026 fiscal year 19
and in an aggregate amount of eighteen million twenty-eight thousand two hundred seventeen 20
dollars ($18,028,217) for the 2026-2027 fiscal year. The due date and frequency of the 21
intergovernmental transfer required by this section shall be determined by DHB. The amount of 22
the intergovernmental transfer that each individual LME/MCO is required to make in each fiscal 23
year shall be as follows: 24
2025-2026 2026-2027 25
Alliance Behavioral Healthcare $4,508,857 $4,508,857 26
Partners Health Management $3,544,348 $3,544,348 27
Trillium Health Resources $6,448,693 $6,448,693 28
Vaya Health $3,526,319 $3,526,319 29
SECTION 2.(b) In the event that a county disengages from an LME/MCO and 30
realigns with another LME/MCO during the 2025-2027 fiscal biennium, DHB shall have the 31
authority to reallocate the amount of the intergovernmental transfer that each affected 32
LME/MCO is required to make under subsection (a) of this section, taking into consideration the 33
change in catchment area and covered population, provided that the aggregate amount of the 34
transfers received from all LME/MCOs in each year of the fiscal biennium is achieved. 35
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General Assembly Of North Carolina Session 2025
Page 2 House Bill 491-Second Edition
EFFECTIVE DATE 1
SECTION 3. Except as otherwise provided, this act is effective retroactively to July 2
1, 2025. 3