North Carolina 2025-2026 Regular Session

North Carolina House Bill H485 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		GENERAL ASSEMBLY OF NORTH CAROLINA
2	2		SESSION 2025
3		-	H 1
4		-	HOUSE BILL 485
	3	+	H D
	4	+	HOUSE BILL DRH30222-NL-73
	5	+
5	6
6	7
7	8		Short Title: Adult Care Home Medicaid PCS Coverage. (Public)
8		-	Sponsors: Representatives Sauls and Potts (Primary Sponsors).
9		-	For a complete list of sponsors, refer to the North Carolina General Assembly web site.
10		-	Referred to: Health, if favorable, Judiciary 1, if favorable, Rules, Calendar, and Operations of
11		-	the House
12		-	March 25, 2025
13		-	H485 -v-1
	9	+	Sponsors: Representative Sauls.
	10	+	Referred to:
	11	+
	12	+	DRH30222 -NL-73
14	13		A BILL TO BE ENTITLED 1
15	14		AN ACT TO REQUIRE A REQUEST FOR FEDERAL APPROVAL TO EXTEND 2
16	15		MEDICAID ELIGIBILITY FOR PERSONAL CARE SERVICES TO CERTAIN 3
17	16		INDIVIDUALS RESIDING IN ADULT CARE HOMES. 4
18	17		The General Assembly of North Carolina enacts: 5
19	18		SECTION 1. In conjunction with the requirements of Section 9E.26 of S.L. 6
20	19		2023-134 for the Department of Health and Human Services, Division of Health Benefits (DHB), 7
21	20		to explore options available to increase access to Medicaid services for dual eligibles that provide 8
22	21		alternatives to nursing home placements, DHB shall consult with stakeholders and shall submit 9
23	22		to the Centers for Medicare and Medicaid Services (CMS) a request that meets all of the 10
24	23		following goals: 11
25	24		(1) Provides Medicaid coverage of personal care services to individuals who 12
26	25		reside in licensed adult care homes and special care units and whose income 13
27	26		exceeds the limit for participation in the State-County Special Assistance 14
28	27		Program authorized under G.S. 108A-40, but does not exceed either (i) one 15
29	28		hundred eighty percent (180%) of the federal poverty level, for individuals 16
30	29		who, but for their income, would qualify for State-County Special Assistance 17
31	30		at the basic rate under G.S. 108A-42.1 or (ii) two hundred percent (200%) of 18
32	31		the federal poverty level, for individuals who, but for their income, would 19
33	32		qualify for State-County Special Assistance at the enhanced rate under 20
34	33		G.S. 108A-42.1. 21
35	34		(2) Ensures that the cost of any new Medicaid coverage being requested is offset 22
36	35		by savings or cost avoidance. 23
37	36		(3) Ensures compliance with applicable legal requirements. 24
38	37		SECTION 2. DHB shall take any actions necessary to implement this act and shall 25
39	38		submit the appropriate request to CMS within 90 days after this act becomes law. DHB shall only 26
40	39		implement the Medicaid coverage described in the request if (i) the request is approved by CMS 27
41	40		and (ii) the request meets all of the goals in Section 1 of this act. 28
42	41		SECTION 3. This act is effective when it becomes law. 29
	42	+	H.B. 485
	43	+	Mar 24, 2025
	44	+	HOUSE PRINCIPAL CLERK