NC House Republicans Fully Fund & Protect Medicaid

North Carolina House Republicans led the charge to fully fund and protect Medicaid, while enacting key reforms. House Bill 696 provides the $319 million needed to prevent a funding shortfall and includes accountability measures to reduce waste, fraud, and abuse.

Key Provisions in HB 696:

• Full Funding: Allocates $319 million from the Medicaid Contingency Reserve to cover the rebase shortfall retroactive to July 2025, ensuring uninterrupted care through June 2026 for over 3 million North Carolinians.

• Work Requirements: Requires 80 hours per month of work, education, or community service for Medicaid expansion beneficiaries.

• Eligibility Verification: Mandates six-month redeterminations, a three-month lookback period, and stronger checks — limiting self-attestation and referring unverifiable immigration status to federal authorities.

• Fraud, Waste & Abuse Crackdown: Funds a performance audit by the State Auditor and gives managed care organizations better tools for detection and utilization management.

• Cost Controls: Raise inpatient hospital copays to the federal maximum of $25.

• Autism Therapy Standards: Strengthens qualifications and sets supervision requirements for Applied Behavior Analysis (ABA) providers serving children with autism.

• Additional Oversight: Directs DHHS to implement further efficiency measures and improve program integrity.

House Republicans are committed to protecting taxpayers, ensuring Medicaid serves those who need it most, and building a sustainable program for North Carolina families.