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Medicaid Rates/Ambulatory Surgical Centers

IntroducedSenate
Kevin CorbinRepublican

Re-ref Com On Appropriations/Base Budget2025-03-26

No floor votes recorded.

This bill requires North Carolina's Medicaid program to increase reimbursement rates paid to ambulatory surgical centers (outpatient surgery facilities) to at least 95% of the Medicare fee schedule, effective July 1, 2025. The bill appropriates $6.9 million in state funds annually, which will leverage $12.6 million in federal matching funds, for a total of approximately $19.5 million per year.

  • Supporters argue that higher Medicaid reimbursement rates will improve access to surgical care by making it financially sustainable for ambulatory surgical centers to serve Medicaid patients.
  • They contend that pegging rates to Medicare standards ensures fair compensation and helps these facilities remain competitive, potentially reducing wait times and expanding capacity for outpatient procedures.
  • Opponents may argue that the bill increases state spending during a time of fiscal constraints, committing $6.9 million annually from the General Fund.
  • They may also question whether rate increases are the most cost-effective way to improve access, or suggest that the funds could address other healthcare priorities or be used more strategically to target underserved areas.

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