North CarolinaMedicaid would limit facility-fee payments by care location
If it becomes law, North Carolina would direct Medicaid not to reimburse certain outpatient facility fees outside listed hospital and surgery settings, as federal law allows.
What it does
Medicaid would not reimburse separate facility fees for outpatient services outside a hospital’s main campus, a facility with an emergency department, or an ambulatory surgery facility, to the extent federal law allows.
Argument forMedicaid could avoid paying separate facility charges for outpatient care at locations outside the listed hospital and surgery settings.
Argument againstProviders at excluded locations might lose Medicaid payment for facility fees, which could make it harder for them to cover those sites’ operating costs.
More detail
The Department of Health and Human Services would direct Medicaid not to reimburse certain facility fees. The limit covers fees for services outside a hospital’s main campus, a facility that includes an emergency department, or an ambulatory surgery facility. A campus includes the main building, nearby areas, certain structures within 250 yards, and other areas recognized as part of the campus. The limit applies only to the extent federal law allows it. A facility fee is a separate charge for outpatient services at a hospital-based facility, meant to cover operating costs and billed regardless of how care is provided. The act would take effect when it becomes law and be implemented as soon as practicable. After June 30, 2027, the department would not have to maintain program changes required by the act.
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Where it stands
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- May 12Withdrawn From CalLatest
- May 12Re-ref Com On Rules, Calendar, and Operations of the HouseMinor
- May 11Cal Pursuant 36(b)
- May 11Placed On Cal For 05/13/2026
- May 7Regular Message Sent To House
- May 7Regular Message Received For Concurrence in S Com Sub
- May 6Passed 2nd ReadingMinor
- Vote recorded Second Reading. Result: pass.Upper
- May 6Passed 3rd ReadingPassed Senate
- May 5Reptd FavMinor
- Apr 30Reptd Fav Com SubstituteMinor
- Apr 30Com Substitute Adopted
- Apr 30Re-ref Com On Rules and Operations of the SenateMinor
- 2025
- May 19Withdrawn From Com
- May 19Re-ref to Health Care. If fav, re-ref to Rules and Operations of the SenateMinor
- May 7Passed 2nd ReadingMinor
- Vote recorded Second Reading. Result: pass.Lower
- May 7Passed 3rd ReadingPassed House
- May 7Special Message Sent To Senate
- May 7Special Message Received From House
- May 7Passed 1st ReadingMinor
- May 7Ref To Com On Rules and Operations of the SenateMinor
- May 6Reptd FavMinor
- May 6Re-ref Com On Rules, Calendar, and Operations of the HouseMinor
- May 6Reptd FavMinor
- May 6Cal Pursuant Rule 36(b)
- May 6Placed On Cal For 05/07/2025
- Apr 29Reptd Fav Com SubstituteMinor
- Apr 29Re-ref Com On Regulatory ReformMinor
- Apr 3Passed 1st ReadingMinor
- Apr 3Ref to the Com on Health, if favorable, Regulatory Reform, if favorable, Rules, Calendar, and Operations of the HouseMinor
- Apr 2FiledIntroduced
Healthcare