SB 808 — Medicaid Funding Act.
Last action — Signed by Gov. 7/2/2020
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✓Introduced
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✓In Committee
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✓Passed Senate
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✓Passed House
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✓To Executive
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6Enacted
This bill has been enacted into law. Introduced May 19, 2020. Enacted.
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Enacted
Current position in the legislative process.
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5 sponsors
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Bill Text
What changed in the latest version
660 added · 778 removedPlain-language change summary
The changes made to Senate Bill 808 involved the addition of specific provisions related to funding for the Department of Health and Human Services for the 2020-2021 fiscal year. This means that the bill now explicitly allocates recurring funding for healthcare programs during this time frame, which is important because it ensures that necessary health services can continue without interruption. By clearly stating this funding, it helps secure financial support for programs that are crucial for public health in North Carolina.
GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2019 S 21 SENATE BILL 808 Appropriations/Base Budget Committee Substitute Adopted 6/10/20 Short Title:
Medicaid FundingTransformation Act.Necessities.
Senators Brown, Harrington, and B.
Jackson (Primary Sponsors).
Rules and Operations of the Senate May 20, 2020 A BILL TO BE ENTITLED AN ACT APPROPRIATINGTO APPROPRIATE FUNDS FOR THE DOROTHEAIMPLEMENTATION DIXOF CAMPUSMEDICAID RELOCATIONTRANSFORMATION PROJECT AND FORTO THEMAKE CHILDOTHER WELFARENECESSARY CASEMEDICAID MANAGEMENTTRANSFORMATION-RELATED COMPONENTCHANGES. OF NORTH CAROLINA FAMILIES ACCESSING SERVICES THROUGH TECHNOLOGY (NC FAST);
APPROPRIATING CORONAVIRUS RELIEF FUNDS FOR BEHAVIORAL HEALTH AND CRISIS SERVICES;
APPROPRIATING FUNDS FOR THE OPERATION OF THE NORTH CAROLINA MEDICAID PROGRAM AND THE IMPLEMENTATION OF MEDICAID TRANSFORMATION;
AND MAKING MEDICAID TRANSFORMATION-RELATED CHANGES.
7 PART I.
DOROTHEAINTRODUCTION DIX CAMPUS RELOCATION PROJECT SECTION 1.(a)1.1. There is transferred from the General Fund to the State Capital and Infrastructure Fund the sum of fifteen million dollars ($15,000,000) in nonrecurring funds for the 2020-2021 fiscal year.
SECTION1.(b)The Thereisprovisions appropriatedfromtheStateCapitalof and InfrastructureFund to the Office of State Budget andAct, ManagementChapter the143C sum of fifteen million dollars ($15,000,000) in nonrecurring funds for the 2020-2021General fiscalStatutes, yearare toreenacted beand allocatedshall forremain thein Dorotheafull Dixforce campusand relocationeffect projectand withare theincorporated Departmentin ofthis Healthact andby Humanreference. Services.
SECTION 1.(c)1.2. The Department of Administration, in collaboration with the Department of Health and Human Services, shall select land located in Wake Countysuitable for the Dorothea Dix campus relocation project.
TheDepartmental fundsreceipts, appropriatedas defined in thisG.S. Part shall be used for planning expenses associated with the relocation project.
SECTION143C-1-1, 1.(d)are Thisappropriated Partfor becomesthe effective2020-2021 Julyfiscal 1,year 2020.up to the amounts needed to implement the provisions in this act for the 2020-2021 fiscal year.
SECTION 1.3.
Except where expressly repealed or amended by this act, the provisions of any other legislation enacted during the 2019 Regular Session expressly appropriating funds to an agency, a department, or an institution covered under this act, shall remain in effect.
FUNDSDELAY FORIMPLEMENTATION CHILD WELFARE CASE MANAGEMENT COMPONENT OF NCMEDICAID FASTTRANSFORMATION SECTION 2.(a)2.1. There is appropriated from the General Fund to the Department of HealthandHumanServices,DivisionofCentralManagementandSupport,thesumofsixmillion one hundred fifty-four thousand four hundred eighty dollars ($6,154,480) in nonrecurring funds for the 2020-2021 fiscal year for updates and changes to the child welfare case management component of the North Carolina Families Accessing Services through Technology (NC FAST) system, including child welfare program changes in accordance with the federal Family First Prevention Services Act, updates for the Comprehensive Child Welfare Information System (CCWIS), funding for the Independent Verification and Validation (IV&V) contract, and risk assessment tool changes under Rylan's Law, S.L.
2017-41.Subdivision (4) of Section 3 of S.L.
*S808-v-2* General Assembly Of North Carolina Session 2019 SECTION 2.(b) This section becomes effective July 1, 2020.
3 PART III.
FUND BEHAVIORAL HEALTH ANDCRISIS SERVICES INRESPONSE TO THE COVID-19 PANDEMIC SECTION 3.(a) The State Controller shall transfer the sum of fifty million dollars ($50,000,000) in nonrecurring funds for the 2020-2021 fiscal year from the Coronavirus Relief Reserve established in Section 2.1 of S.L.
2020-4 to the Coronavirus Relief Fund established in Section 2.2 of that same act (Coronavirus Relief Fund).
SECTION 3.(b) There is appropriated from the Coronavirus Relief Fund to the Office of State Budget and Management (OSBM) the sum of fifty million dollars ($50,000,000) in nonrecurring funds for the 2020-2021 fiscal year, to allocate to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (DMH/DD/SAS), for distribution to the local management entities/managed care organizations (LME/MCOs) to fund behavioral health and crisis services in response to the COVID-19 pandemic.
The DMH/DD/SAS shall determine how to distribute these funds among the LME/MCOs.
SECTION 3.(c) The requirements and limitations set forth in Part I of S.L.
2020-4 apply to the funds appropriated in this Part.
The OSBM shall include the funds transferred and appropriated in this section in the report required under Section 1.7 of S.L.
2020-4.
SECTION 3.(d) This Part becomes effective July 1, 2020.
PART IV.
DISALLOW TRANSFER OF MEDICAID BUDGET SURPLUS SECTION 4.(a) Notwithstanding Section 11F.2(d) of S.L.
2017-57, Section 3.6(b)(1) of S.L.
2019-242, or any other provision of law to the contrary, the Department of Health and Human Services, Division of Health Benefits, shall not transfer any amount of the certified Medicaid budget surplus calculated for the 2019-2020 fiscal year to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, for allocation to local management entities/managed care organizations (LME/MCOs) to offset any reduction in single-stream funding.
SECTION 4.(b) This section becomes effective June 30, 2020.
PART V.
FUNDS FOR OPERATION OF THE MEDICAID PROGRAM SECTION5.1.(a) Funds receivedbytheDepartment ofHealthand Human Services, Division of Health Benefits, during the 2019-2020 fiscal year due to the acceleration of the federal fiscal year 2019-2020 MRI/GAP Plan that (i) represent the portion of the State's annual Medicaid payment, as defined in G.S.
108A-121, attributable to the quarter July 1, 2020, through September 30, 2020, and (ii) have not been expended by June 30, 2020, shall not revert at the end of the fiscal year but shall remain available and shall be used for the Medicaid program for the 2020-2021 fiscal year.
SECTION 5.1.(b) This section becomes effective June 30, 2020.
SECTION 5.2.
There is appropriated from the General Fund to the Department of Health and Human Services, Division of Health Benefits, the sum of one million four hundred thousand dollars ($1,400,000) in nonrecurring funds for the 2020-2021 fiscal year to be used for the implementation of an electronic visit verification (EVV) system that will be used for personal care services and home health services under the Medicaid program.
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SECTION5.3.(a) Ofthefundsappropriatedto theDepartment ofHealth andHuman Services, Division of Health Benefits, for the 2019-2020 fiscal year that have not been expended by June 30, 2020, and in addition to the funds described in Section 5.1 of this act, the sum of thirty million dollars ($30,000,000) in nonrecurring funds shall not revert at the end of the fiscal year but shall remain available and shall be used for the Medicaid and NC Health Choice programs rebase in the 2020-2021 fiscal year.
Page 2 Senate Bill 808-Second Edition General Assembly Of North Carolina Session 2019 SECTION 5.3.(b) This section becomes effective June 30, 2020.
SECTION 5.4.
The State Controller shall transfer the sum of eighty-four million dollars ($84,000,000) in nonrecurring funds for the 2020-2021 fiscal year from funds available in the Medicaid Transformation Reserve in the General Fund to the Department of Health and Human Services, Division of Health Benefits, to be used for the Medicaid and NC Health Choice programs rebase.
Funds transferred under this section are appropriated for the purpose set forth in this section.
SECTION 5.5.
Notwithstanding G.S.
143C-4-11, as enacted by Section 14 of this act, the sum of one hundred thirty-six million dollars ($136,000,000) in nonrecurring funds for the 2020-2021 fiscal year shall be transferred from the Medicaid Contingency Reserve in the General Fund to the Department of Health and Human Services, Division of Health Benefits, to be used for the Medicaid and NC Health Choice programs rebase.
Funds transferred under this section are appropriated for the purpose set forth in this section.
SECTION 5.6.
There is appropriated from the General Fund the sum of two hundred thirteen million dollars ($213,000,000) in nonrecurring funds for the 2020-2021 fiscal year to the Department of Health and Human Services, Division of Health Benefits, to be used for the Medicaid and NC Health Choice programs rebase.
SECTION 5.7.
Except as otherwise provided, this Part becomes effective July 1, 2020.
PART VI.
MEDICAID ELIGIBILITY REDETERMINATIONS SECTION 6.
No later than 60 days after the expiration of the declared nationwide public health emergency as a result of the 2019 novel coronavirus, each county department of social services, and any federally recognized Native American tribe within the State that has assumed responsibilityfor the Medicaid program pursuant to G.S.
108A-25(e), shall do all of the following:
(1) Redetermine Medicaid eligibility for all Medicaid beneficiaries for whom eligibility was continued as a result of Section 6008(b)(3) of P.L.
116-127, including all of the following:
a.
Beneficiaries who were due for an annual or other periodic renewal of their Medicaid eligibility.
b.
Beneficiaries who experienced a change in circumstance affecting their Medicaid eligibility.
c.
Beneficiaries whose Medicaid eligibility was affected by information received through post-eligibility verification.
(2) Provide notice to beneficiaries determined to be ineligible for Medicaid as a result of subdivision (1) of this section, in accordance with G.S.
108A-79.
PART VII.
MEDICAID TRANSFORMATION NECESSITIES DELAY IMPLEMENTATION OF MEDICAID TRANSFORMATION SECTION 7.(a) Subdivision (4) of Section 3 of S.L.
NolaterthanNo July1,2021.–Capitatedcontractsshallbegin.DHHSmayphase recipient enrollment on a regional basis, provided that initial recipient enrollment shall be complete no later than fiveJanuary months after the date capitated contracts are required to begin." SECTION 7.(b) If Medicaid capitated payments do not begin on July 1, 2021,2021. as required by Subdivision (4) of Section 3 of S.L.
2015-245,– asCapitated amendedcontracts byshall Sectionbegin. 4 of S.L.
SenateDHHS Billmay 808-Secondphase Editionrecipient Pageenrollment 3on Generala Assemblyregional Ofbasis, Northprovided Carolinathat Sessioninitial 2019recipient 2018-49enrollment andshall subsectionbe (a)complete ofno thislater section,than then,five tomonths compensateafter for the delay,date thecapitated Departmentcontracts ofare Healthrequired and Human Services, Division of Health Benefits, shall make the following monthly payments to prepaidbegin." healthPART plansIII. (PHPs), as defined in G.S.
108D-1,FUNDS forFOR eachOPERATION fullOF monthTHE afterMEDICAID JunePROGRAM 30,SECTION 2021,3.1. that Medicaid capitated payments have not been paid to the PHPs:
(1)There Fouris millionappropriated dollarsfrom ($4,000,000)the toGeneral eachFund PHPa thatsufficient hassum beenin awardedrecurringfundingforthe a2020-2021fiscal statewideyearto standardtheDepartment benefitofHealth planand PHPHuman capitatedServices, contractDivision as of JuneHealth 1,Benefits, 2020.to be used for the Medicaid and NC Health Choice programs rebase.
(2)SECTION A3.2. prorated amount of four million dollars ($4,000,000) to each PHP that has been awarded a regional standard benefit plan PHP capitated contract as of June1,2020,baseduponthenumberofregionsthe PHPiscontractedtoserve.
SECTIONThere 7.(c)is Theappropriated paymentsfrom requiredthe underGeneral subsectionFund (b)a ofsufficient thissum sectionin shallrecurringfundingforthe not2020-2021fiscal beyearto requiredtheDepartment forofHealth anyand monthHuman inServices, whichDivision the failure of aHealth PHPBenefits, tofor receivecontracts, apersonnel, capitationand paymentprojects afterrelated Julyto 1,transitioning 2021,to isMedicaid causedmanaged bycare. the PHP.
USE*S808-v-1* OF MEDICAID TRANSFORMATION FUND FOR MEDICAID TRANSFORMATION NEEDS SECTION 8.(a) The State Controller shall transfer the sum of nineteen million four hundred twenty thousand dollars ($19,420,000) for the 2020-2021 fiscal year from funds available in the Medicaid Transformation Reserve in the General FundAssembly toOf theNorth MedicaidCarolina TransformationSession Fund2019 established2 underPART SectionIV. 12H.29 of S.L.
USE OF MEDICAID TRANSFORMATION FUND FOR MEDICAID TRANSFORMATION NEEDS SECTION 4.1.
The State Controller shall transfer a sufficient sum for the nonrecurring Medicaid transformation needs in the 2020-2021 fiscal year from funds available in the Medicaid Transformation Reserve in the General Fund to the Medicaid Transformation Fund established under Section 12H.29 of S.L.
SECTION 8.(b)4.2. Subject to the fulfillment of conditions specified in subsection (c) of this section, the sum of nineteen million four hundred twenty thousand dollars ($19,420,000) in nonrecurring funds for the 2020-2021 fiscal year from the Medicaid Transformation Fund may be transferred to the Department of Health and Human Services, Division of Health Benefits (DHB), for the sole purpose of providing the State share for qualifying needs directly related to Medicaid transformation, as required by S.L.
Funds from the Medicaid Transformation Fund may be transferred to the Department of Health and Human Services, Division of Health Benefits (DHB), as needed for the purpose of paying claims related to services billed under the fee-for-service payment model for recipients who are being, or have been, transitioned to managed care, otherwise known as "claims run out." Funds may be transferred to DHB as the need to pay claims run out arises and need not be transferred in one lump sum.
To the extent that any funds are transferred under this section, the funds are appropriated for the purpose set forth in this section.
SECTION 4.3.(a) Subject to the fulfillment of conditions specified in subsection (b) of this section, nonrecurring funds for the 2020-2021 fiscal year from the Medicaid Transformation Fund may be transferred to the Department of Health and Human Services, Division of Health Benefits (DHB), for the sole purpose of providing the State share for nonrecurring qualifying needs directly related to Medicaid transformation, as required by S.L.
Funds may be transferred to DHB as nonrecurring qualifying needs arise during the 2020-2021 fiscal year and need not be transferred in one lump sum.
(7) ProviderOther experience.nonrecurring needs identified by DHB, as determined in consultation with the Office of State Budget and Management.
SECTION 8.(c)4.3.(b) A request by the Department of Health and Human Services, Division of Health Benefits (DHB), for the transfer of funds pursuant to this section shall be made to the Office of State Budget and Management (OSBM) and shall include the amount requested and the specific nonrecurring qualifying need for which the funds are to be used.
(1) The amount requested is to be used for a nonrecurring qualifying need in the 2020-2021 fiscal year.
(2) The amount requested provides a State share that will not result in total requirements that exceed sixty-three million one hundred twentyforty thousandmillion dollars ($63,120,000)($140,000,000) in nonrecurring funds for the 2020-2021 fiscal year.
SECTION 8.(d)4.3.(c) Any federal funds received in any fiscal year by the Department of Health and Human Services, Division of Health Benefits (DHB), that represent a return of State Page 4 Senate Bill 808-Second Edition General Assembly Of North Carolina Session 2019 share already expended on a qualifying need related to the funds received by DHB under this section shall be deposited into the Medicaid Transformation Fund.
SECTIONPage 8.(e)2 ThisSenate sectionBill becomes808-First effectiveEdition JulyGeneral 1,Assembly 2020.Of North Carolina Session 2019 PART V.
5 REPEAL OF PAST DIRECTIVE TO ELIMINATE GME TO ALIGN WITH MEDICAID TRANSFORMATION SECTION 9.5.1.
MEDICAID6 TRANSFORMATIONPART HOTLINEVI. OPTION SECTION 10.
TheMEDICAID DepartmentTRANSFORMATION ofHOTLINE HealthOPTION andSECTION Human6.1. Services shall ensure that the existing DHHS Customer Service hotline is responsive to questions posed by a Medicaid beneficiary or provider or by the general public that are related to the rollout of Medicaid transformation.
DURABLEThe MEDICALDepartment EQUIPMENTof RATEHealth FLOORand SECTIONHuman 11.Services shall ensure that the existing DHHS Customer Service hotline is responsive to questions posed by a Medicaid beneficiary or provider or by the general public that are related to the rollout of Medicaid Transformation.
ForPART theVII. first three years of the initial standard benefit plan prepaid health plan capitated contracts required under Article 4 of Chapter 108D of the General Statutes, the rate floor for durable medical equipment under managed care shall be set at one hundred percent (100%) of the Medicaid fee-for-service rates for durable medical equipment.
TRIBAL OPTION/MEDICAID TRANSFORMATION SECTION 12.(a)7.1.(a) TheTheDepartment Department of Health and Human Services maymaycontract contract with an Indian managed care entity(IMCE) or an Indian healthhealthcareprovider(IHCP),as careprovider(IHCP),as definedunder 42 C.F.R.
(4) The management or provision of specialized services covered by a behavioralBH healthIDD andTailored intellectual/developmentalPlan disabilities (BH/IDD) tailored plan in accordance with G.S.
SECTION 12.(b)7.1.(b) G.S.
…." SECTION 12.(c)7.1.(c) G.S.
Senate Bill 808-Second Edition Page 5 General Assembly Of North Carolina Session 2019 "(e) Beginning on the date that capitated contracts under Article 4 of Chapter 108D of the General Statutes begin, LME/MCOs shall cease managing Medicaid services for all Medicaid recipients other than recipients described in G.S.
Senate Bill 808-First Edition Page 3 General Assembly Of North Carolina Session 2019 (3) Capitation payments under contracts between the Division of Health Benefits and the LME/MCOs shall be made directly to the LME/MCO by the Division of Health Benefits." SECTION 12.(d)7.1.(d) The Department of Health and Human Services is authorized to seek approval from CMS and submit any necessary State Plan Amendments and waivers, or any amendments thereto, to implement the provisions of this section.
REVISE8 ANDPART RENAMEVIII. THE SUPPLEMENTAL PAYMENT PROGRAM FOR ELIGIBLE MEDICAL PROFESSIONAL PROVIDERS SECTION 13.(a) The Department of Health and Human Services shall revise the supplemental payment program for eligible medical professional providers described in the Medicaid State Plan, Attachment 4.19-B, Section 5, Pages 2 and 3, as required by this section.
REVISE AND RENAME THE SUPPLEMENTAL PAYMENT PROGRAM FOR ELIGIBLE MEDICAL PROFESSIONAL PROVIDERS SECTION 8.1.(a) The Department of Health and Human Services shall revise the supplemental payment program for eligible medical professional providers described in the Medicaid State Plan, Attachment 4.19-B, Section 5, Pages 2 and 3, as required by this section.
Effective JulyJanuary 1, 2021, the following two changes to the program shall be implemented:
SECTION 13.(b)8.1.(b) The limitation on total payments made under the Average Commercial Rate Supplemental and Directed Payment Program for eligible medical professional providersshallapplytothecombinedamountofpaymentsmadeassupplementalpaymentsunder the State Plan and payments made as directed payments under the managed care system and shall be based on the amount of supplemental payments for services provided during the 2018-2019 fiscal year.year as follows:
(1) For services provided onduring orthe afterperiod JulyJanuary 1, 2021, through June 30, 2021, the total annual supplemental and directed payments made under the AverageAverageCommercialRateSupplemental CommercialandDirectedPaymentProgramshall Rate Supplemental and Directed Payment Program shall not exceed onefifty hundred percent (100%)(50%) of the gross supplemental payments for services provided by eligible medical providers during the 2018-2019 fiscal year,year increased atby thean start of each State fiscal year byan inflation factor determined bytheby the Department of Health and Human Services, Division of Health Benefits.
SECTION(2) 13.(c)For Consistentservices withprovided theon existingor supplementalafter paymentJuly program1, for2021, eligiblemedicalprofessionalproviders,theDepartmentofHealthandHumanServicesshalllimit the total amountannual of supplemental and directed payments thatmade mayunder bethe receivedAverage byCommercial Rate Supplemental and Directed Payment Program shall not exceed one hundred percent (100%) of the gross supplemental payments for services provided by eligible medical providers affiliatedduring with the East2018-2019 Carolinafiscal Universityyear, Brodyincreased Schoolat the start of Medicineeach andState fiscal year by an inflation factor determined by the UniversityDepartment of NorthHealth Carolinaand atHuman ChapelServices, HillDivision of Health CareBenefits. System.
AverageSECTION commercial8.1.(c) rateConsistent Pagewith 6the Senateexisting Billsupplemental 808-Secondpayment Editionprogram Generalfor Assemblyeligiblemedicalprofessionalproviders,theDepartmentofHealthandHumanServices Ofshalllimit Norththe Carolinatotal Sessionamount 2019of supplemental payments and directed payments shallthat notmay be madereceived forby servicesthe providedeligible inproviders Wakeaffiliated County.with the East Carolina University Brody School of Medicine and the University of North Carolina at Chapel Hill Health Care System.
SECTIONAverage 13.(d)commercial Therate Departmentsupplemental ofpayments Health and Humandirected Servicespayments isshall not authorizedbe tomade make any modifications to the supplemental payment program for eligibleservices medicalprovided professionalin providers,Wake exceptCounty. as authorized by this section.
SECTIONPage 13.(e)4 EffectiveSenate JulyBill 1,808-First 2021,Edition SectionGeneral 12H.13(e)Assembly Of North Carolina Session 2019 SECTION 8.1.(d) The Department of S.L.Health and Human Services is not authorized to make any modifications to the supplemental payment program for eligible medical professional providers, except as authorized by this section.
SECTION 8.1.(e) Effective January 1, 2021, Section 12H.13(e) of S.L.
97 MEDICAIDPART CONTINGENCYIX. RESERVE CODIFICATION SECTION 14.
MEDICAID CONTINGENCY RESERVE CODIFICATION SECTION 9.1.
– The Medicaid Contingency Reserve is established as a reserve to be used onlyonlyfor for budget shortfalls in the Medicaid or NC Health Choice program.programs.
This report shall include an analysis of the causes of the shortfall, such as (i) unanticipated enrollment and mix of enrollment, (ii) unanticipated growth or utilization within particular service areas, (iii) errors in the data or analysis used to project the Medicaid or NC Health Choice budget, (iv) the failure of the program to achieve budgeted savings, (v) other factors and market trends that have impacted the price of or spending for services, (vi) variations in receipts from prior years or from assumptions used to prepare the Medicaid and NC Health Choice budgetsbudget for the current fiscal year, or (vii) other factors.
(c) Nothing in this section shall be construed to limit the authority of the Governor to carry out the Governor's duties under the Constitution." REVISEPART ANDX. UPDATE HOSPITAL ASSESSMENTS SECTION 15.1.(a) Effective July1, 2021, Article 7 of Chapter 108A of the General Statutes is repealed.
REVISE AND UPDATE HOSPITAL ASSESSMENTS SECTION 15.1.(a1)10.1.(a) NotwithstandingEffective anyJanuary provision1, of2021, Article 7 of Chapter 108A of the General Statutes tois therepealed. contrary, the equity assessment, UPL assessment, equity payments, and UPL payments required under that Article for the partial year beginning October 1, 2020, and ending June 30, 2021, shall be carried out in accordance with this subsection.
SECTION 10.1.(a1) Notwithstanding any provision of Article 7 of Chapter 108A of the General Statutes to the contrary, the equity assessment, UPL assessment, equity payments, and UPL payments required under that Article for the partial year beginning October 1, 2020, and ending December 31, 2020, shall be carried out in accordance with this subsection.
108A-124 shall be calculated to exclude services rendered after JuneDecember 30,31, 2021.2020.
In order to account for any partial-year adjustments to the equity payments or UPLpayments,UPL payments, the SecretaryofSecretary of the Department of Health and Human Services maymaymake makeanynecessaryadjustments any necessary adjustments to the equity assessment percentage rate, the UPL assessment Senate Bill 808-Second Edition Page 7 General Assembly Of North Carolina Session 2019 percentage rate, any quarterly equity assessment, and any UPL assessment required under G.S.
Senate Bill 808-First Edition Page 5 General Assembly Of North Carolina Session 2019 SECTION 15.1.(a2)10.1.(a2) Subsection (a) of this section does not affect the rights or liabilities of the State, a hospital subject to the equity assessment or the UPL assessment, or another person arising under a statute repealed by subsection (a) of this section or arising under subsection (a1) of this section before the effective date of its repeal.
SECTION 15.1.(b)10.1.(b) Effective JulyJanuary1, 1, 2021, Chapter 108A of the General Statutes is amended by adding a new Article to read:
– An annual amount equal to one hundred twentyten million dollars ($120,000,000)($110,000,000) for the taxable year October 1, 2020, through September 30, 2021, increased each year over the prior year's payment by the percentage specified as the Medicare Market Basket Index less productivity most recently published in the Federal Register.
Page 8 Senate Bill 808-Second Edition General Assembly Of North Carolina Session 2019 A hospital may appeal a determination of the assessment amount owed through a reconsideration review.
Page 6 Senate Bill 808-First Edition General Assembly Of North Carolina Session 2019 (a) Assessments paid under this Article may be included as allowable costs of a hospital for purposes of any applicable Medicaid reimbursement formula, except that assessments paid under this Article shall be excluded from cost settlement.
IfCMS determines that an assessment underthis ArticleArticleis is impermissibleorrevokes approval of an assessment under this Article, then that assessment shall not be imposed and the Department's authority to collect the assessment is repealed.
Senate Bill 808-Second Edition Page 9 General Assembly Of North Carolina Session 2019 (b) The Department shall propose the rate of the base assessment to be imposed under this section when the Department prepares its budget request for each upcoming fiscal year.
Senate Bill 808-First Edition Page 7 General Assembly Of North Carolina Session 2019 (c) The Department shall base the proposed base assessment rate on all of the following factors:
(c) For the partial year beginning JulyJanuary 1, 2021, and ending September 30, 2021, the percentagepercentagedescribed described in subsection (a)(a)ofthis ofsectionshall thisbecalculated sectionbydividing shallthree-fourths be calculated by dividing one fourth of the amount of the State's annual Medicaid payment by the amount collected under the base assessment under G.S.
The proceeds of the assessments imposed under this Part, and all corresponding matching federal funds, must be used to make the State's annual Medicaid payment to the State, to fund payments to hospitals made directly by the Department, to fund a portion of capitation payments to prepaid health plans attributable to hospital care, and to fund the nonfederal share of graduate medical education payments." SECTION 15.1.(b1)10.1.(b1) Notwithstanding any provision of G.S.
108A-131(10), shall be calculated based on the Hospital Cost Report Information System's 20172016 cost report data available through the Centers for Medicare and Medicaid Services.
SECTION 15.1.(c)10.1.(c) The percentage rate to be used in calculating the supplemental assessment under G.S.
108A-141, as enacted in subsection (b) of this section, is two and thirty-twotwenty-six hundredths percent (2.32%)(2.26%) for the taxable year October 1, 2020, through September 30, 2021.
The supplemental assessment shall be imposed only for months beginning on or after JulyJanuary 1, 2021.
The supplemental assessment imposed during the period JulyJanuary 1, 2021, through Page 10 Senate Bill 808-Second Edition General Assembly Of North Carolina Session 2019 September 30, 2021, shall equal one-fourththree-fourths of the amount of supplemental assessment that would have been imposed for the full taxable year.
SECTION15.1.(d)SECTION10.1.(d) The percentage rateto beused in calculatingthe base assessment under G.S.
108A-142, as enacted in subsection (b) of this section, is twoone and fourseventy-seven Page 8 Senate Bill 808-First Edition General Assembly Of North Carolina Session 2019 hundredths percent (2.04%)(1.77%) for the taxable year October 1, 2020, through September 30, 2021.
The base assessment shall be imposed only for months beginning on or after JulyJanuary 1, 2021.
The base assessment imposed during the period JulyJanuary 1, 2021, through September 30, 2021, shall equal one-fourththree-fourths of the amount of base assessment that would have been imposed for the full taxable year.
SECTION 15.2.10.2.
143C-4-11, as enacted by Section 149.1 of this act, the State Controller shall transfer funds from the Medicaid Contingency Reserve to the Department of Health and Human Services, Division of Health Benefits (DHB), only upon request by DHB as needed to cover any shortfall in receipts from the supplemental or base assessmentassessments under G.S.
108A-142, enacted bybysubsection subsection (b) of Section 15.110.1 of this act, and only if the following two conditions are met:
(1) The Office of State Budget and Management (OSBM) has certified that there will be a shortfall in receipts from the supplemental or base assessment.assessments.
(2) OSBM has certified that the amount requested by DHB does not exceed the shortfall in receipts certified by OSBM under subdivision (1) of this section.subsection.
The authority set forth in this section expires June 30, 2022.2021.
GROSSPART PREMIUMSXI. TAX/PREPAID HEALTH PLANS SECTION 16.(a) The title of Article 8B of Chapter 105 of the General Statutes reads as rewritten:
GROSS PREMIUMS TAX/PREPAID HEALTH PLANS SECTION 11.(a) The title of Article 8B of Chapter 105 of the General Statutes reads as rewritten:
"Taxes Upon Insurance Companies.Companies and Prepaid Health Plans." SECTION 16.(b)11.(b) G.S.
97-93 of the Workers' Compensation Act." Senate Bill 808-Second Edition Page 11 General Assembly Of North Carolina Session 2019 SECTION 16.(c)11.(c) G.S.
Senate Bill 808-First Edition Page 9 General Assembly Of North Carolina Session 2019 (a) TaxLevied.–Ataxisleviedinthissectiononinsurers,Article65corporations,health maintenance organizations, prepaid health plans, and self-insurers.
Page 12 Senate Bill 808-Second Edition General Assembly Of North Carolina Session 2019 Gross premiums from business done in this State in the case of prepaid health plans means all capitation payments received by a prepaid health plan from the Department of Health and Human Services for the delivery of services to enrollees in the State Medicaid program or NC Page 10 Senate Bill 808-First Edition General Assembly Of North Carolina Session 2019 Health Choice program in the calendar year.
– An additional tax at the rate of seventy-four hundredths percent (0.74%) applies to gross premiums on Senate Bill 808-Second Edition Page 13 General Assembly Of North Carolina Session 2019 insurance contracts for property coverage.
The tax is imposed on ten percent (10%) of the gross premiums from insurance contracts for automobile physical damage coverage and on one hundred percent (100%) of the gross Senate Bill 808-First Edition Page 11 General Assembly Of North Carolina Session 2019 premiums from all other contracts for property coverage.
The company taypayertaxpayer shall remit the balance by the following March 15 in the same manner provided in this section for annual returns.
– This section does not apply to farmers' mutual assessment fire insurance companies or to fraternal orders or societies that do not operate for a profit and do not Page 14 Senate Bill 808-Second Edition General Assembly Of North Carolina Session 2019 issue policies on any person except members.
105-228.4A." SECTION 16.(d)11.(d) G.S.
Page 12 Senate Bill 808-First Edition General Assembly Of North Carolina Session 2019 … (e) Definitions.
…." SECTION 16.(e)11.(e) G.S.
– An officer, an employee, or an agent of the State who has access to tax information in the course of service to or employment bytheby the State maynotmay not disclose the information to any other person except as provided in this subsection.
…." SECTION 16.(f)11.(f) This section is effective 30 days after it becomes law and applies to capitation payments received by prepaid health plans on or after that date.
HOSPITALPART UNCOMPENSATEDXII. CARE FUND SECTION17.
Article9ofChapter143oftheGeneralHOSPITAL StatutesisUNCOMPENSATED amendedCARE byaddingFUND aSECTION new12.1. section to read:
Article 9 of Chapter 143 of the General Statutes is amended by adding a new section to read:
– The Department of Health and Human Services shall adopt rules for determining eligibilityfor, and allocations of, Hospital Uncompensated Care Fund payments." MEDICAIDPART NONTAXXIII. REVENUE Senate Bill 808-Second Edition Page 15 General Assembly Of North Carolina Session 2019 SECTION 18.
ItMEDICAID isNONTAX theREVENUE intentSECTION of13.1. the General Assemblyto enact legislation before the start of the 2021-2022 fiscal year to reflect changes to nontax revenue in the North Carolina Medicaid program in a managed care environment.
5It PARTis VIII.the intent of the General Assembly to amend Section 2.3(b) of S.L.
MISCELLANEOUS2019-242 SECTIONto 19.1.reflect changes to the handling of nontax revenue in the North Carolina Medicaid program in a managed care environment.
ThePART provisionsXIV. of the State Budget Act, Chapter 143C of the General Statutes, are reenacted and shall remain in full force and effect and are incorporated in this act by reference.
EFFECTIVE DATE Senate Bill 808-First Edition Page 13 General Assembly Of North Carolina Session 2019 SECTION 19.2.14.1.
Departmental receipts, as defined in G.S.
143C-1-1, are appropriated for the 2020-2021 fiscal year up to the amounts needed to implement the provisions in this act for the 2020-2021 fiscal year.
SECTION 19.3.
Except where expressly repealed or amended by this act, the provisions of any other legislation enacted during the 2019 Regular Session expressly appropriating funds to an agency, a department, or an institution covered under this act, shall remain in effect.
PART IX.
EFFECTIVE DATE SECTION 20.
Page 1614 Senate Bill 808-Second808-First Edition
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Action History
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Signed by Gov. 7/2/2020
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Ch. SL 2020-88
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Ratified
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Pres. To Gov. 6/26/2020
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Amend Adopted A1
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Passed 3rd Reading
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Ordered Engrossed
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Special Message Sent To Senate
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Special Message Received For Concurrence in H Com Sub
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Placed on Today's Calendar
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Concurred In H Com Sub
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Ordered Enrolled
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Reptd Fav Com Sub 2
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Cal Pursuant Rule 36(b)
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Added to Calendar
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Passed 2nd Reading
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Reptd Fav
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Cal Pursuant Rule 36(b)
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Withdrawn From Cal
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Re-ref Com On Rules, Calendar, and Operations of the House
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Reptd Fav Com Substitute
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Cal Pursuant Rule 36(b)
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Placed On Cal For 06/23/2020
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Withdrawn From Cal
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Re-ref Com On Finance
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Withdrawn From Com
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Re-ref Com On Appropriations
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Passed 3rd Reading
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Engrossed
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Special Message Sent To House
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Special Message Received From Senate
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Passed 1st Reading
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Ref To Com On Rules, Calendar, and Operations of the House
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Amend Adopted A1
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Passed 2nd Reading
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Reptd Fav
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Reptd Fav
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Re-ref Com On Rules and Operations of the Senate
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Reptd Fav Com Substitute
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Com Substitute Adopted
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Re-ref Com On Finance
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Sequential Referral To Rules and Operations of the Senate Stricken
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Sequential Referral To Finance Added
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Sequential Referral To Rules and Operations of the Senate Added
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Passed 1st Reading
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Ref To Com On Rules and Operations of the Senate
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Withdrawn From Com
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Re-ref to Appropriations/Base Budget. If fav, re-ref to Rules and Operations of the Senate
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Filed
Sponsors
- Brown · Primary
- Harrington · Primary
- Ballard · Cosponsor
- Edwards · Cosponsor
- Brent Jackson · Cosponsor
Sponsorship breakdown
Export CSV (upgrade) →2 sponsors · 3 co-sponsors · 174 not signed on · 2 voted No
Sponsors (2)
- Brown
- Harrington
Co-sponsors (3)
- Ballard
- Edwards
- Brent Jackson Republican
Not signed on (174)
174 members have not signed on to this bill.
Show all 174 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 22 | 1 | 0 | 2 |
| Republican | 33 | 1 | 0 | 1 |
| Unaffiliated | 55 | 0 | 0 | 3 |
| U | 1 | 0 | 0 | 1 |
| Total | 111 | 2 | 0 | 7 |
| % of votes cast | 93% | 2% | 0% | 6% |
How each member voted (120)
| Member | Party | Vote |
|---|---|---|
| Autry | — | Yea |
| Beasley | — | Yea |
| Brewer | — | Yea |
| Clemmons | — | Yea |
| Farmer-Butterfield | — | Yea |
| Floyd | — | Yea |
| Gailliard | — | Yea |
| Garrison | — | Yea |
| Gill | — | Yea |
| Graham | — | Yea |
| Harris | — | Yea |
| Holley | — | Yea |
| Hunt | — | Yea |
| Hunter | — | Yea |
| Jackson | — | Yea |
| Lucas | — | Yea |
| Martin | — | Yea |
| Montgomery | — | Yea |
| Queen | — | Yea |
| Richardson | — | Yea |
| Russell | — | Yea |
| vonHaefen | — | Yea |
| Wray | — | Yea |
| Boles | — | Yea |
| Bumgardner | — | Yea |
| Carter | — | Yea |
| Cleveland | — | Yea |
| Conrad | — | Yea |
| Davis | — | Yea |
| Dobson | — | Yea |
| Elmore | — | Yea |
| Faircloth | — | Yea |
| Fraley | — | Yea |
| Grange | — | Yea |
| Hardister | — | Yea |
| Horn | — | Yea |
| Hurley | — | Yea |
| P. Jones | — | Yea |
| Lewis | — | Yea |
| McElraft | — | Yea |
| McGrady | — | Yea |
| McNeill | — | Yea |
| Moore | — | Yea |
| Presnell | — | Yea |
| Rogers | — | Yea |
| Saine | — | Yea |
| Sasser | — | Yea |
| Speciale | — | Yea |
| Szoka | — | Yea |
| Yarborough | — | Yea |
| Zachary | — | Yea |
| Fisher | — | Not Voting |
| Insko | — | Not Voting |
| Terry | — | Not Voting |
| C. Smith | — | Yea |
| K. Baker | — | Yea |
| K. Smith | — | Yea |
| R. Smith | — | Yea |
| Allison A. Dahle | Democratic | Not Voting |
| Amos L. Quick, III | Democratic | Yea |
| Becky Carney | Democratic | Yea |
| Brandon Lofton | Democratic | Yea |
| Brian Turner | Democratic | Yea |
| Carolyn G. Logan | Democratic | Yea |
| Cecil Brockman | Democratic | Not Voting |
| Cynthia Ball | Democratic | Yea |
| Dante Pittman | Democratic | Yea |
| Deb Butler | Democratic | Yea |
| Eric Ager | Democratic | Yea |
| Gale Adcock | Democratic | Yea |
| Garland E. Pierce | Democratic | Yea |
| Graig Meyer | Democratic | Yea |
| Joe John | Democratic | Yea |
| Marcia Morey | Democratic | Yea |
| Mary Belk | Democratic | Yea |
| Pricey Harrison | Democratic | Nay |
| Robert T. Reives, II | Democratic | Yea |
| Shelly Willingham | Democratic | Yea |
| Sydney Batch | Democratic | Yea |
| Terence Everitt | Democratic | Yea |
| Tracy Clark | Democratic | Yea |
| Vernetta Alston | Democratic | Yea |
| Zack Hawkins | Democratic | Yea |
| Bobby Hanig | Republican | Yea |
| Brenden H. Jones | Republican | Yea |
| Chris Humphrey | Republican | Yea |
| Dean Arp | Republican | Yea |
| Dennis Riddell | Republican | Yea |
| Destin Hall | Republican | Yea |
| Donna McDowell White | Republican | Yea |
| Donny Lambeth | Republican | Yea |
| Edward C. Goodwin | Republican | Yea |
| Frank Iler | Republican | Yea |
| Harry Warren | Republican | Yea |
| Hugh Blackwell | Republican | Yea |
| Jake Johnson | Republican | Yea |
| Jay Adams | Republican | Yea |
| Jeffrey C. McNeely | Republican | Yea |
| Jimmy Dixon | Republican | Yea |
| John A. Torbett | Republican | Yea |
| John R. Bell, IV | Republican | Yea |
| John Sauls | Republican | Yea |
| Julia C. Howard | Republican | Yea |
| Keith Kidwell | Republican | Nay |
| Kelly E. Hastings | Republican | Yea |
| Kevin Corbin | Republican | Yea |
| Kyle Hall | Republican | Yea |
| Larry C. Strickland | Republican | Yea |
| Larry W. Potts | Republican | Yea |
| Lisa S. Barnes | Republican | Yea |
| Mark Brody | Republican | Yea |
| Mitchell S. Setzer | Republican | Yea |
| Phil Shepard | Republican | Not Voting |
| Sarah Stevens | Republican | Yea |
| Stephen M. Ross | Republican | Yea |
| Steve Jarvis | Republican | Yea |
| W. Ted Alexander | Republican | Yea |
| William D. Brisson | Republican | Yea |
| Carla D. Cunningham | U | Not Voting |
| Nasif Majeed | U | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 9 | 0 | 0 | 0 |
| Unaffiliated | 25 | 0 | 0 | 3 |
| Republican | 12 | 0 | 0 | 1 |
| Total | 46 | 0 | 0 | 4 |
| % of votes cast | 92% | 0% | 0% | 8% |
How each member voted (50)
| Member | Party | Vote |
|---|---|---|
| deViere | — | Yea |
| Fitch | — | Yea |
| Foushee | — | Yea |
| Marcus | — | Yea |
| Nickel | — | Yea |
| Peterson | — | Yea |
| Smith | — | Yea |
| Woodard | — | Yea |
| Ballard | — | Yea |
| Brown | — | Yea |
| Bryan | — | Yea |
| J. Davis | — | Yea |
| Edwards | — | Yea |
| Gallimore | — | Yea |
| Gunn | — | Yea |
| Harrington | — | Yea |
| Horner | — | Yea |
| Johnson | — | Yea |
| Krawiec | — | Yea |
| Newton | — | Yea |
| Perry | — | Yea |
| Steinburg | — | Yea |
| Wells | — | Yea |
| Searcy | — | Not Voting |
| VanDuyn | — | Not Voting |
| Tillman | — | Not Voting |
| D. Davis | — | Yea |
| J. Jackson | — | Yea |
| Dan Blue | Democratic | Yea |
| Gladys A. Robinson | Democratic | Yea |
| Jay J. Chaudhuri | Democratic | Yea |
| Joyce Waddell | Democratic | Yea |
| Michael Garrett | Democratic | Yea |
| Mujtaba A. Mohammed | Democratic | Yea |
| Natalie S. Murdock | Democratic | Yea |
| Paul A. Lowe, Jr. | Democratic | Yea |
| Tracy Clark | Democratic | Yea |
| Bill Rabon | Republican | Yea |
| Brent Jackson | Republican | Yea |
| Carl Ford | Republican | Yea |
| Danny Earl Britt, Jr. | Republican | Not Voting |
| Jim Burgin | Republican | Yea |
| Norman W. Sanderson | Republican | Yea |
| Phil Berger | Republican | Yea |
| Ralph Hise | Republican | Yea |
| Tom McInnis | Republican | Yea |
| Vickie Sawyer | Republican | Yea |
| W. Ted Alexander | Republican | Yea |
| W. Ted Alexander | Republican | Yea |
| Warren Daniel | Republican | Yea |
Subjects
Frequently asked questions
- Who sponsors SB 808?
- SB 808 is sponsored by Brown, Harrington, Ballard, Edwards, and Brent Jackson (Republican).
- What is the current status of SB 808?
- This bill has been enacted into law. Introduced May 19, 2020. Enacted.
- Where can I track SB 808?
- Track SB 808 free on One Click Politics — get push/email alerts when it moves.
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