Medicaid SUD Services Rate Adjustment Act.

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 1
SENATE BILL 567

Short Title: Medicaid SUD Services Rate Adjustment Act. (Public)
Sponsors: Senators Meyer, Adcock, and Batch (Primary Sponsors).
Referred to: Rules and Operations of the Senate
March 26, 2025
*S567-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO ESTABLISH AND ADJUST MEDICAID REIMBURSEMENT RATES FOR 2
SUBSTANCE USE DISORDER SERVICES. 3
The General Assembly of North Carolina enacts: 4
SECTION 1. The Department of Health and Human Services, Division of Health 5
Benefits, shall make all of the following adjustments to the Medicaid Program: 6
(1) Increase rates paid for ASAM level 2.1 substance use intensive outpatient 7
program services to two hundred f ifty-five dollars and twenty -eight cents 8
($255.28) per diem. 9
(2) Increase the rates paid for ASAM level 2.5 substance use comprehensive 10
outpatient treatment program services to four hundred dollars ($400.00) per 11
diem. 12
(3) Establish coverage for ASAM level 3.1 clinically managed low -intensity 13
Residential Treatment services. A rate of three hundred fifty dollars ($350.00) 14
per diem shall be paid for these services. 15
(4) Establish coverage for ASAM level 3.3 clinically managed high -intensity 16
treatment services. A rate of two hundred fifty dollars ($250.00) per diem shall 17
be paid for these services. 18
(5) Establish coverage for ASAM level 3.5 clinically managed residential 19
treatment services. A rate of five hundred fifty dollars ($550.00) per diem 20
shall be paid for these services. 21
(6) Increase the rates paid for ASAM level 3.7 substance use medically monitored 22
community residential treatment services to six hundred fifty dollars 23
($650.00) per diem. 24
(7) Increase the rates paid for ASAM level 3.7 non -hospital medical 25
detoxification services to seven hundred fifty -six dollars and sixty-five cents 26
($756.65) per diem. 27
SECTION 2. There is appropriated from the General Fund to the Department of 28
Health and Human Services, Division of Health Benefits, the sum of fifteen milli on dollars 29
($15,000,000) in recurring funds for each year of the 2025 -2027 fiscal biennium to be used to 30
effectuate the rate changes under this act. These funds shall provide a State match for 31
twenty-seven million four hundred thousand dollars ($27,400,000) in recurring federal funds for 32
each year of the 2025-2027 fiscal biennium, and those funds are appropriated to the Division of 33
Health Benefits for the same purpose. 34
SECTION 3. This act is effective July 1, 2025. 35