NC S350

DHHS must establish a single standardized electronic format for all local management entities/managed care organizations (LME/MCOs) to submit encounter data for Medicaid and State-funded mental health, developmental disabilities, and substance abuse services, with reporting due to the Joint Legislative Oversight Committee by February 1, 2018.

LME/MCO standard contracts must include quality outcome measures for mental health, developmental disabilities, and substance use disorders, and LME/MCOs are designated as the sole entities authorized to operate the 1915(b)/(c) Medicaid Waiver.

Area directors must be full-time employees appointed by the area board and cannot be employed in any other capacity; their compensation including salary, benefits, and bonuses is subject to Secretary and State Human Resources Director approval and cannot exceed 30% above the average salary of other LME/MCO area directors.

LME/MCOs may only subcontract specific managed care functions (information systems, customer service, claims processing, provider credentialing, professional services, treatment plan development, and referrals) with prior Secretary approval and cannot subcontract other functions or non-service activities.

Area board composition requirements include at least 11 and no more than 21 voting members with specific representation from county commissioners, consumers, family members, and professionals in healthcare, administration, finance, insurance/business, social services, and law; county programs and consolidated human services agencies are eliminated from the statute.