House Bill 229 would require the North Carolina Department of Health and Human Services, Division of Health Benefits, to amend the Medicaid State Plan so that services provided by licensed ambulatory surgical centers are reimbursed at no less than 95% of the Medicare Ambulatory Surgical Center fee schedule in effect each January 1. The bill ties the Medicaid rate standard to the federal Medicare fee schedule and directs the state to make the initial rate changes once the State Plan amendment is approved by CMS.
The bill also appropriates recurring state funds to support the higher reimbursement levels. It provides $10.476 million from the General Fund each year of the 2025-2027 biennium, which is intended to draw down $19.135 million in recurring federal funds each year for the same purpose. The act would take effect July 1, 2025.
Impact
H229 would amend North Carolina Medicaid policy by setting a statutory minimum reimbursement benchmark for ambulatory surgical centers and requiring a corresponding Medicaid State Plan amendment. It would increase recurring state spending and leverage federal matching funds, affecting DHHS, Medicaid providers, and ambulatory surgical centers that serve Medicaid beneficiaries. The bill would not broadly change all Medicaid rates, but it would specifically raise payment levels for licensed outpatient surgical facilities.
Sentiment
The available bill text and context suggest a generally supportive, provider-focused measure aimed at improving Medicaid reimbursement for ambulatory surgical centers. There are no recorded committee transcripts or votes in the provided material, so there is no documented debate or formal opposition in the record supplied. The bill’s structure, including a dedicated appropriation and a clear reimbursement floor, indicates an intent to advance the measure as a funding and access issue.
Contention
The main likely point of contention is fiscal: the bill requires a recurring General Fund appropriation and depends on federal matching funds, so lawmakers concerned about state budget impact may question the cost. Another possible issue is policy design, since the bill sets Medicaid payment rates for one provider category at a percentage of Medicare, which could prompt debate over whether that benchmark is appropriate or whether it creates preferential treatment relative to other providers. No specific objections or supporters are documented in the provided transcripts or votes.