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H485 • 2025

Adult Care Home Medicaid PCS Coverage.

Adult Care Home Medicaid PCS Coverage.

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Sauls, Potts, Belk, Brockman, G. Brown, Butler, Carney, Cervania, Colvin, Cotham, Crawford, Cunningham, Greenfield, Harrison, Hawkins, F. Jackson, Johnson-Hostler, Lambeth, Logan, Longest, McNeely, Morey, Moss, Penny, R. Pierce, Pike, Prather, Reives, Rubin, Ward, Willingham
Last action
2025-05-27
Official status
Re-ref to Health Care. If fav, re-ref to Finance. If fav, re-ref to Rules and Operations of the Senate
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

Adult Care Home Medicaid PCS Coverage.

H485-SMTR-15(e1)-v-2 (2025-04-15): Adult Care Home Medicaid PCS Coverage.

What This Bill Does

  • H485-SMTR-15(e1)-v-2 (2025-04-15): Adult Care Home Medicaid PCS Coverage.
  • H485-SMTR-18(e1)-v-2 (2025-04-15): Adult Care Home Medicaid PCS Coverage.
  • H485-SMTR-8(e1)-v-3 (2025-04-08): Adult Care Home Medicaid PCS Coverage.

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

Filed

Plain English: 2025-2026 General Assembly HOUSE BILL 485: Adult Care Home Medicaid PCS Coverage.

  • 2025-2026 General Assembly HOUSE BILL 485: Adult Care Home Medicaid PCS Coverage.
  • Committee: House Judiciary 1.
  • If favorable, re -refer to Rules, Calendar, and Operations of the House Date: April 15, 2025 Introduced by: Reps.
  • Sauls, Potts Prepared by: Jennifer Hillman Staff Attorney Analysis of: First Edition Kara McCraw Director *H485-SMTR-15(e1)-v-2* Legislative Analysis Division 919-733-2578 This bill analysis was prepared by the nonpartisan legislative staff for the use of legislators in their deliberations and does not constitute an official statement of legislative intent.
Filed

Plain English: 2025-2026 General Assembly HOUSE BILL 485: Adult Care Home Medicaid PCS Coverage.

  • 2025-2026 General Assembly HOUSE BILL 485: Adult Care Home Medicaid PCS Coverage.
  • Committee: House Rules, Calendar, and Operations of the House Date: April 15, 2025 Introduced by: Reps.
  • Sauls, Potts Prepared by: Jennifer Hillman Staff Attorney Analysis of: First Edition Kara McCraw Director *H485-SMTR-18(e1)-v-2* Legislative Analysis Division 919-733-2578 This bill analysis was prepared by the nonpartisan legislative staff for the use of legislators in their deliberations and does not constitute an official statement of legislative intent.
  • OVERVIEW: House Bill 485 would require the Department of Health and Human Services, Division of Health Benefits (DHB) to consult with stakeholders and submit a request for federal approval to provide Medicaid personal care services to individuals who reside in adult care homes or special care units and who have incomes above the threshold for eligibility for the State-County Special Assistance program but below a specified level.
Filed

Plain English: 2025-2026 General Assembly HOUSE BILL 485: Adult Care Home Medicaid PCS Coverage.

  • 2025-2026 General Assembly HOUSE BILL 485: Adult Care Home Medicaid PCS Coverage.
  • Committee: House Health.
  • If favorable, re -refer to Judiciary 1.
  • If favorable, re -refer to Rules, Calendar, and Operations of the House Date: April 8, 2025 Introduced by: Reps.

Bill History

  1. 2025-05-27 Senate

    Re-ref to Health Care. If fav, re-ref to Finance. If fav, re-ref to Rules and Operations of the Senate

  2. 2025-05-27 Senate

    Withdrawn From Com

  3. 2025-04-28 Senate

    Ref To Com On Rules and Operations of the Senate

  4. 2025-04-28 Senate

    Passed 1st Reading

  5. 2025-04-28 Senate

    Regular Message Received From House

  6. 2025-04-17 House

    Regular Message Sent To Senate

  7. 2025-04-16 House

    Passed 3rd Reading

  8. 2025-04-16 House

    Passed 2nd Reading

  9. 2025-04-15 House

    Placed On Cal For 04/16/2025

  10. 2025-04-15 House

    Cal Pursuant Rule 36(b)

  11. 2025-04-15 House

    Reptd Fav

  12. 2025-04-15 House

    Re-ref Com On Rules, Calendar, and Operations of the House

  13. 2025-04-15 House

    Reptd Fav

  14. 2025-04-08 House

    Re-ref Com On Judiciary 1

  15. 2025-04-08 House

    Reptd Fav

  16. 2025-03-25 House

    Ref to the Com on Health, if favorable, Judiciary 1, if favorable, Rules, Calendar, and Operations of the House

  17. 2025-03-25 House

    Passed 1st Reading

  18. 2025-03-24 House

    Filed

Official Summary Text

H485-SMTR-15(e1)-v-2
(2025-04-15): Adult Care Home Medicaid PCS Coverage.
H485-SMTR-18(e1)-v-2
(2025-04-15): Adult Care Home Medicaid PCS Coverage.
H485-SMTR-8(e1)-v-3
(2025-04-08): Adult Care Home Medicaid PCS Coverage.

Current Bill Text

Read the full stored bill text 
GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 485

Short Title: Adult Care Home Medicaid PCS Coverage. (Public)
Sponsors: Representatives Sauls and Potts (Primary Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Health, if favorable, Judiciary 1, if favorable, Rules, Calendar, and Operations of
the House
March 25, 2025
*H485-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO REQUIRE A REQUEST FOR FEDERAL APPROVAL TO EXTEND 2
MEDICAID ELIGIBILITY FOR PERSONAL CARE S ERVICES TO CERTAIN 3
INDIVIDUALS RESIDING IN ADULT CARE HOMES. 4
The General Assembly of North Carolina enacts: 5
SECTION 1. In conjunction with the requirements of Section 9E.26 of S.L. 6
2023-134 for the Department of Health and Human Services, Division of Health Benefits (DHB), 7
to explore options available to increase access to Medicaid services for dual eligibles that provide 8
alternatives to nursing home placements, DHB shall consult with stakeholders and shall submit 9
to the Centers for Medicare and Medicaid Services (CMS) a request that meets all of the 10
following goals: 11
(1) Provides Medicaid coverage of personal care service s to individuals who 12
reside in licensed adult care homes and special care units and whose income 13
exceeds the limit for participation in the State -County Special Assistance 14
Program authorized under G.S. 108A-40, but does not exceed either (i) one 15
hundred eighty percent (180%) of the federal poverty level, for individuals 16
who, but for their income, would qualify for State-County Special Assistance 17
at the basic rate under G.S. 108A-42.1 or (ii) two hundred percent (200%) of 18
the federal poverty level, for indiv iduals who, but for their income, would 19
qualify for State -County Special Assistance at the enhanced rate under 20
G.S. 108A-42.1. 21
(2) Ensures that the cost of any new Medicaid coverage being requested is offset 22
by savings or cost avoidance. 23
(3) Ensures compliance with applicable legal requirements. 24
SECTION 2. DHB shall take any actions necessary to implement this act and shall 25
submit the appropriate request to CMS within 90 days after this act becomes law. DHB shall only 26
implement the Medicaid coverage described in the request if (i) the request is approved by CMS 27
and (ii) the request meets all of the goals in Section 1 of this act. 28
SECTION 3. This act is effective when it becomes law. 29