NC S657

LME/MCOs must submit quarterly reports to DHHS beginning October 1, 2023, for four years, including emergency department stays over 24 hours, individuals unable to access providers within 30 days, and retained funds from unused approved services.

LME/MCOs must report provider network changes by type and identify eligible individuals not receiving approved mental, behavioral, or substance use services through the organization.

Secretary of DHHS must adopt rules by December 31, 2023, requiring LME/MCOs to maintain fewer than two boarded beneficiaries per county in emergency departments at any time (boarded defined as stays over 24 hours after medical clearance).

LME/MCOs must ensure individuals access willing and available healthcare providers and begin receiving all approved services within 45 days of approval at least 85% of the time, excluding specialized medical services with extended wait times.

Failure to meet access benchmarks for two consecutive quarters constitutes failure to provide minimally adequate services, triggering corrective action procedures under G.S. 122C-124.1.