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2016 Health Law Section Annual MeetingApril 29,2016
NCBA Health Law Section
Medicaid Reform in North Carolina -Forecasting Structure and
Preparing for the Transition
05/02/2023 2
Representative Nelson Dollar:NC General Assembly, House District 36
Cody R. Hand: VP & Deputy General Counsel, North Carolina Hospital Association
Lou Patalano IV:VP & Deputy General Counsel, Blue Cross Blue Shield NC
Andrew Walsh: Chief Legal Officer & General Counsel, Partners Behavioral Health Management
Panel
05/02/2023 3
I. Materials & Highlights of New Law II. Perspectives & Prognostications
Legislative (Rep. Nelson Dollar) Hospital & Healthcare Systems (Cody Hand) Insurers and Commercial Plans (Lou
Patalano) Behavioral Health--LME/MCOs (Andrew
Walsh) III. Q&A
Overview
05/02/2023 4
1. Seminar PDF -- Table of Contents (p.2) Mostly Articles and Legislative Reports (moving target)
2. Online Resources www.ncleg.net http://www.ncdhhs.gov/nc-medicaid-reform
3. Highlights of New Law (SL 2015-245) Integrated Medicaid Managed Care (PDF, pp. 4-16) PHPs (CPs and PLEs) Capitated Contracts Waivers, SPAs & Federal Approval DHB v DMA (+ DOI) JLOC Medicaid & JLOC HHS Timelines and Deadlines
Materials & Highlights
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05/02/2023 6
Physical Health
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Behavioral Health
05/02/2023 8
Legislative (Rep. Nelson Dollar) Hospital & Healthcare Systems (Cody Hand) Insurers and Commercial Plans (Lou
Patalano) Behavioral Health & LME/MCOs (Andrew
Walsh)
Perspectives & Prognostications
05/02/2023 9
MCE Population Medicaid Members
Counties
Partners 909,394 296,658 8Smoky 1,074,157 23Cardinal 2,411,453 410,065 16CenterPoint 542,516 4Alliance 1,766,635 378,136 4Sandhills 1,079,786 9Eastpoint 829,229 351,696 12Trillium 1,260,778 24
TOTALS 9,873,948 1,436,555 100
LME/MCO (PIHP) CONSOLIDATIONS
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Questions?
05/02/2023 11
Contact Information Andrew M. Walsh,
[email protected], 704-884-2634 Other Panelists: On Request