Senate Bill 567, titled the Medicaid SUD Services Rate Adjustment Act, directs the North Carolina Department of Health and Human Services, Division of Health Benefits, to increase Medicaid reimbursement rates for several substance use disorder treatment services and to add coverage for certain residential treatment levels that are not currently specified in the bill. The affected services are organized under the American Society of Addiction Medicine (ASAM) framework and include intensive outpatient treatment, comprehensive outpatient treatment, multiple levels of residential treatment, medically monitored community residential treatment, and non-hospital medical detoxification.
The bill sets specific per diem payment rates for each covered service level, including new coverage and rate increases for ASAM levels 3.1, 3.3, and 3.5, and higher reimbursement for ASAM levels 2.1, 2.5, and 3.7 services. To fund these changes, the bill appropriates $15 million in recurring General Fund dollars each year of the 2025-2027 biennium, which is intended to draw down $27.4 million in recurring federal Medicaid funds annually as matching support. The act would take effect July 1, 2025.
Impact
This bill would amend Medicaid financing and reimbursement policy in North Carolina by requiring DHHS to pay higher rates for specified substance use disorder treatment services and by establishing Medicaid coverage for additional residential treatment categories. It would also create a recurring state appropriation and corresponding federal match to support the new payment structure, affecting Medicaid providers, treatment facilities, and beneficiaries who rely on SUD services.
Sentiment
Based on the bill text and the absence of recorded committee debate or votes in the provided materials, the measure appears to be a straightforward funding and access proposal with an affirmative policy orientation toward expanding and stabilizing Medicaid reimbursement for addiction treatment. The bill’s structure suggests support for increasing provider participation and service availability in the behavioral health and substance use treatment system.
Contention
No committee transcripts or vote records were provided, so there is no documented opposition or negotiated controversy in the available materials. The main policy issue inherent in the bill is fiscal: it requires a recurring state appropriation to support higher Medicaid rates and new coverage, which may raise questions about budget impact, provider payment adequacy, and the extent of federal matching funds. Any contention would likely center on cost, implementation, and whether the proposed rates are sufficient to expand access to treatment.
Medical assistance rate adjustments established for physician professional services, residential service rates increased, and statewide reimbursement rate for behavioral health home services required.
Payment rates established for certain substance use disorder treatment services, and vendor eligibility recodified for payments from the behavioral health fund.