GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 1
SENATE BILL 464
Short Title: Inmate Medicaid Suspension/Team-Based Care. (Public)
Sponsors: Senator Burgin (Primary Sponsor).
Referred to: Rules and Operations of the Senate
March 25, 2025
*S464 -v-1*
A BILL TO BE ENTITLED 1
AN ACT TO REQUIRE TE AM-BASED CARE COORDI NATION IN MEDICAID 2
SUBSTANCE USE TREATM ENT AND MODIFY THE M EDICAID PROGRAM TO 3
SUSPEND RATHER THAN TERMINATE MEDICAID E LIGIBILITY FOR 4
INCARCERATED INDIVIDUALS. 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), is directed, in coordination with a working group of stakeholders established by 8
DHB, to develop a team-based care coordination Medicaid service that includes, at a minimum, 9
screening for alcohol use disorder, opioid use disorder, and other mild to moderate substance use 10
disorders; prescription medications for opioid use disorder and alcohol use disorder; recovery 11
support; and case management. 12
SECTION 1.(b) No later that October 1, 2025, the Department of Health and Human 13
Services, Division of Health Benefits, shall submit a report to the Joint Legislative Oversight 14
Committee on Medicaid and the Fiscal Research Division containing details on the new Medicaid 15
service developed in accordance with this section. The report shall include all of the following: 16
(1) The State share of the cost of the service. 17
(2) The intended start date for the coverage of the service. 18
(3) The types of PHP capitated contracts that will cover the service and any 19
related proposed statutory changes to Article 4 of Chapter 108D of the General 20
Statutes. 21
SECTION 1.(c) The Department of Health and Human Services, Division of Health 22
Benefits, is directed to develop a Statewide campaign to (i) educate healthcare providers and 23
community leaders about any changes made to the Medicaid program related to the treatment of 24
alcohol use disorder, opioid use disorder, and other mild to moderate substance use disorders; 25
(ii) train interested providers in clinical care for alcohol use disorder, opioid use disorder, and 26
other mild to moderate substance use disorders; and (iii) encourage substance use disorder 27
provider participation in the Medicaid program. 28
SECTION 2. As required by the federal Consolidated Appropriations Act, 2024, 29
Public Law 118-42, the Department of Health and Human Services, Division of Health Benefits, 30
shall update relevant Medicaid policy and, as necessary, the Medicaid State Plan to suspend, 31
rather than terminate, Medicaid coverage upon a Medicaid recipient's incarceration. To facilitate 32
implementation of the updated policy before the required federal deadline and potentially as early 33
as July 1, 2025, the North Carolina Department of Health and Human Services and the North 34
Carolina Department of Adult Corrections shall enter into a memorandum of understanding to 35
share data concerning the Medicaid eligibility status of individuals entering confinement at or 36 General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 464-First Edition
released from North Carolina jails. The Department of Adult Corrections is further directed to 1
update its internal and external policies and manuals to reflect any changes necessary for 2
implementation of the updated policy in compliance with federal law. 3
SECTION 3. This act is effective when it becomes law. 4