RALEIGH: DHHS to unveil Medicaid revamp Monday - WNCN: News, Weather

DHHS to unveil Medicaid revamp Monday

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RALEIGH, N.C. -

Gov. Pat McCrory's health agency plans to present itsMedicaid reform proposal to the General Assembly Monday, his administrationannounced today.

The legislature and McCrory are trying to bring more certainty to Medicaid spending after repeated annual shortfalls that siphons away funds for education and other priorities.

Medicaid is the federal-state health insurance program for the poor and disabled and serves 1.7 million people in North Carolina, costing $13 billion annually, of which $3.5 billion is paid by the state. Lawmakers aren't in agreement on a solution.

Last month, state Department of Health and Human Servicespresented a framework for revamping the program inline with demands by the state's doctors and hospitals to an advisory group setup by McCrory and lawmakers.

The health agency proposed expanding the roughly two dozen"accountable care organizations" operating statewide. They wouldtreat physical ailments but not dental, behavioral, substance-abuse orlong-term care needs.

The Medicaid revamp, which state lawmakers and federalofficials must approve, could begin taking effect as early as July 2015, DHHSsaid.

McCrory and Republican legislative leaders have blamedspiraling Medicaid costs left by preceding Democratic administrations for notproviding teachers and state workers with raises last year. But Medicaid hasalso proved tough to manage under the GOP's watch.

A group of North Carolina doctors filed a class-actionlawsuit in January after flawed computer programs severely delayed paymentsthey were due for treating Medicaid patients.

The lawsuit alleges that managers at DHHS and itscontractors were negligent in launching NCTracks, a nearly $500 millioncomputer system intended to streamline the process of filing Medicaid claimsand issuing payments.

The lawsuit alleged NCTracks's software was riddled withthousands of errors that led to delays of weeks and sometimes months beforedoctors and hospitals received payment. That forced some medical practices toborrow money to meet payroll and others to stop treating Medicaid patients, thelawsuit said.

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