| 12 | 13 | | A BILL TO BE ENTITLED 1 |
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| 13 | 14 | | AN ACT TO ESTABLISH AND ADJUST MEDICAID REIMBURSEMENT RATES FOR 2 |
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| 14 | 15 | | SUBSTANCE USE DISORDER SERVICES. 3 |
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| 15 | 16 | | The General Assembly of North Carolina enacts: 4 |
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| 16 | 17 | | SECTION 1. The Department of Health and Human Services, Division of Health 5 |
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| 17 | 18 | | Benefits, shall make all of the following adjustments to the Medicaid Program: 6 |
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| 18 | 19 | | (1) Increase rates paid for ASAM level 2.1 substance use intensive outpatient 7 |
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| 19 | 20 | | program services to two hundred fifty-five dollars and twenty-eight cents 8 |
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| 20 | 21 | | ($255.28) per diem. 9 |
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| 21 | 22 | | (2) Increase the rates paid for ASAM level 2.5 substance use comprehensive 10 |
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| 22 | 23 | | outpatient treatment program services to four hundred dollars ($400.00) per 11 |
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| 23 | 24 | | diem. 12 |
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| 24 | 25 | | (3) Establish coverage for ASAM level 3.1 clinically managed low-intensity 13 |
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| 25 | 26 | | Residential Treatment services. A rate of three hundred fifty dollars ($350.00) 14 |
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| 26 | 27 | | per diem shall be paid for these services. 15 |
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| 27 | 28 | | (4) Establish coverage for ASAM level 3.3 clinically managed high-intensity 16 |
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| 28 | 29 | | treatment services. A rate of two hundred fifty dollars ($250.00) per diem shall 17 |
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| 29 | 30 | | be paid for these services. 18 |
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| 30 | 31 | | (5) Establish coverage for ASAM level 3.5 clinically managed residential 19 |
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| 31 | 32 | | treatment services. A rate of five hundred fifty dollars ($550.00) per diem 20 |
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| 32 | 33 | | shall be paid for these services. 21 |
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| 33 | 34 | | (6) Increase the rates paid for ASAM level 3.7 substance use medically monitored 22 |
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| 34 | 35 | | community residential treatment services to six hundred fifty dollars 23 |
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| 35 | 36 | | ($650.00) per diem. 24 |
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| 36 | 37 | | (7) Increase the rates paid for ASAM level 3.7 non-hospital medical 25 |
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| 37 | 38 | | detoxification services to seven hundred fifty-six dollars and sixty-five cents 26 |
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| 38 | 39 | | ($756.65) per diem. 27 |
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| 39 | 40 | | SECTION 2. There is appropriated from the General Fund to the Department of 28 |
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| 40 | 41 | | Health and Human Services, Division of Health Benefits, the sum of fifteen million dollars 29 |
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| 41 | 42 | | ($15,000,000) in recurring funds for each year of the 2025-2027 fiscal biennium to be used to 30 |
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| 42 | 43 | | effectuate the rate changes under this act. These funds shall provide a State match for 31 |
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| 43 | 44 | | twenty-seven million four hundred thousand dollars ($27,400,000) in recurring federal funds for 32 |
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| 44 | 45 | | each year of the 2025-2027 fiscal biennium, and those funds are appropriated to the Division of 33 |
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| 45 | 46 | | Health Benefits for the same purpose. 34 |
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| 46 | 47 | | SECTION 3. This act is effective July 1, 2025. 35 |
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