NC Senate votes for managed care Medicaid overhaul

The move would offer a set amount of money per patient for care to managed care plans and would take administration of the program out of the hands of the state Department of Health and Human Services and into the hands of a politically appointed board.

Raleigh News & Observer: NC Senate Votes For Medicaid Overhaul
A major Medicaid overhaul that largely disregards the wishes of health care providers, the state House and Gov. Pat McCrory won overwhelming support in the state Senate on Thursday in a 28-17 vote. The overhaul would introduce to the state commercial managed care for Medicaid patients, a move that doctors and hospitals are fighting. But after several years of overruns, legislators crave "budget predictability" for Medicaid (Bonner, 7/24).

WRAL: Senate Votes To Overhaul Medicaid
The proposal, House Bill 1181, would remove Medicaid from the Department of Health and Human Services, setting it up as an independent agency called the Department of Medical Services governed by an independent, although politically appointed, board. Under the proposal, the state would end its direct fee-for-service management of the program, contracting it out to managed care and accountable care organizations. The contracts would be "capitated," offering a set amount of money for care per patient (Leslie, 7/24).

North Carolina Health News: Senate Moves Medicaid Reform Bill, But Objections Abound
If a majority of members of the North Carolina Senate get their way, the state's Medicaid program is up for big changes. A bill that passed the Senate Thursday afternoon would speed up implementation of both provider-led plans and commercial managed care plans to compete to cover patients in Medicaid, the state and federally funded program that provides health care coverage for low-income children, pregnant women, low-income elderly and people with disabilities. The bill would also carve the Division of Medical Assistance – which runs Medicaid – out of the Department of Health and Human Services and create a freestanding executive Department of Medical Benefits, which would be run by a seven-member board (Hoban, 7/25).

Elsewhere, a report examines the state's "Medicaid gap" --

Raleigh News & Observer: Many Low-Income N.C. Workers Are Locked Out Of Medicaid
They're construction workers, waitresses and cashiers. They care for our children and elderly parents, clean our offices and bathrooms. But they go without health insurance because their incomes aren't high enough to qualify for federal subsidies and too high to qualify for North Carolina's current Medicaid program for low-income and disabled citizens. More than half of the 689,000 uninsured adults North Carolinians who fall into this so-called "Medicaid gap" are employed in jobs that are critical to the state's economy, according to a report released Thursday by the North Carolina Justice Center, the North Carolina Community Health Center Association and Families USA (Garloch, 7/25).