NC S32

Establishes a hospital assessment program to generate revenue for improving Medicaid payments to hospitals treating Medicaid and uninsured patients.

Imposes quarterly assessments on North Carolina hospitals calculated as a percentage of total hospital costs, with proceeds used to obtain matching federal Medicaid funds.

Exempts state-owned hospitals, UNC medical school primary teaching hospitals, critical access hospitals, long-term care hospitals, psychiatric hospitals, and rehabilitation hospitals from assessments; public hospitals exempt from equity assessment only.

Creates two assessment types: equity assessments to fund Medicaid equity payments and UPL assessments to fund upper pay limit gap payments to eligible hospitals.

Designates $43 million in annual state Medicaid payments to be allocated between equity and UPL assessment categories, with quarterly distributions to hospitals upon payment of their respective assessments.