March 10, 2020

The Joint Legislative Oversight Committee on Medicaid and NC Health Choice convened this afternoon to receive an update from NCDHHS Secretary Mandy Cohen, updates on Medicaid and NC Health Choice, and an overview of Medicaid eligibility groups.

Following Governor Cooper’s press conference this afternoon where he proclaimed that NC was in a state of emergency, Secretary Cohen provided the committee with updated information on the COVID-19 virus. New Medicaid policy changes will be announced tomorrow in response to the coronavirus. Changes include allowing Medicaid providers to bill for defined telephonic services, updating pharmacy policies remove refill limits, allowing reimbursement for masks for ill patients, and eliminating prior authorizations for oxygen equipment and related supplies.

Next, Secretary Cohen addressed the delay of Medicaid transformation in NC, and stated that transitioning to a managed-care system can not go live until a sufficient budget was in place for NCDHHS. Secretary Cohen also gave an overview of activity that would need to happen in order to restart the transition to managed-care. Since the delay of Medicaid transformation, NCDHHS has winded down work on the transition but is keeping an inventory on what the department will need to go live again. Secretary Cohen explained to the committee that the longer they wait to implement managed-care, the harder it will be to restart. Until a new and sufficient budget is in place, we do not know when Medicaid transformation can go live in NC.

Representatives from NCDHHS also updated the committee on enrollment numbers and finances with Medicaid and NC Health Choice. Medicaid enrollment in NC has continued to be relatively flat. Furthermore, NC Medicaid expects to be “on budget” with no reversion to the state for FY2019-20. Lastly, the committee received an overview of Medicaid eligibility groups in NC.