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2016 Health Law Section Annual MeetingApril 29,2016

NCBA Health Law Section

Medicaid Reform in North Carolina -Forecasting Structure and

Preparing for the Transition

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Representative Nelson Dollar:NC General Assembly, House District 36

Cody R. Hand: VP & Deputy General Counsel, North Carolina Hospital Association

Lou Patalano IV:VP & Deputy General Counsel, Blue Cross Blue Shield NC

Andrew Walsh: Chief Legal Officer & General Counsel, Partners Behavioral Health Management

Panel

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I. Materials & Highlights of New Law II. Perspectives & Prognostications

Legislative (Rep. Nelson Dollar) Hospital & Healthcare Systems (Cody Hand) Insurers and Commercial Plans (Lou

Patalano) Behavioral Health--LME/MCOs (Andrew

Walsh) III. Q&A

Overview

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1. Seminar PDF -- Table of Contents (p.2) Mostly Articles and Legislative Reports (moving target)

2. Online Resources www.ncleg.net http://www.ncdhhs.gov/nc-medicaid-reform

3. Highlights of New Law (SL 2015-245) Integrated Medicaid Managed Care (PDF, pp. 4-16) PHPs (CPs and PLEs) Capitated Contracts Waivers, SPAs & Federal Approval DHB v DMA (+ DOI) JLOC Medicaid & JLOC HHS Timelines and Deadlines

Materials & Highlights

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Physical Health

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Behavioral Health

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Legislative (Rep. Nelson Dollar) Hospital & Healthcare Systems (Cody Hand) Insurers and Commercial Plans (Lou

Patalano) Behavioral Health & LME/MCOs (Andrew

Walsh)

Perspectives & Prognostications

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MCE Population Medicaid Members

Counties

Partners 909,394 296,658 8Smoky 1,074,157 23Cardinal 2,411,453 410,065 16CenterPoint 542,516 4Alliance 1,766,635 378,136 4Sandhills 1,079,786 9Eastpoint 829,229 351,696 12Trillium 1,260,778 24

TOTALS 9,873,948 1,436,555 100

LME/MCO (PIHP) CONSOLIDATIONS

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Questions?

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Contact Information Andrew M. Walsh,

awalsh@partnersbhm.org, 704-884-2634 Other Panelists: On Request