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 directs the state to make the initial rate changes once the Centers for Medicare and Medicaid Services approves the state plan amendment.
The bill also appropriates $10.476 million in recurring General Fund dollars for each year of the 2025-2027 biennium to support the Medicaid rate increase. Those state dollars are intended to draw down an additional $19.135 million in recurring federal Medicaid funds each year for the same purpose. The act would take effect July 1, 2025.
HB229 would change North Carolina Medicaid reimbursement policy for ambulatory surgical centers by setting a statutory minimum payment level tied to Medicare rates. It would require a state plan amendment and create a recurring appropriation from the General Fund, with corresponding federal matching funds, affecting DHHS, Medicaid providers, and the state budget.
The available context shows no committee debate or recorded votes, so there is no documented opposition or support beyond the bill’s introduction and referral. Based on the bill text, the measure appears designed to increase provider reimbursement and strengthen ambulatory surgical center participation in Medicaid, suggesting a generally provider-supportive policy approach.
The main likely point of contention is fiscal: the bill requires a recurring state appropriation and depends on federal matching funds, which may raise budget concerns. Another possible issue is the policy choice to peg Medicaid rates to a percentage of Medicare, which could be debated by lawmakers concerned about cost growth, provider access, or whether ambulatory surgical centers should receive preferential rate treatment compared with other Medicaid providers.