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Commissioner Fraley - GEMS - To Appropriate Fund Balance for FY25 Excess Directed Payment Revenues ($373,980) and to Appropriate FY26 Excess Directed Payment Revenues ($86,817) for Payment to the State in Support of the Managed Care Directed Payment Fee Schedule.
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STAFF CONTACT
Mark Lamphiear - GEMS - 704-866-3202
BUDGET IMPACT
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General Fund: Increase Fund Balance Appropriated $373,980, Increase Directed Payment revenues $86,817, and Increase Directed Payment expenditures $460,797.
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BACKGROUND
In FY25 the County received $373,980 more than budgeted in Directed Payment revenues. These additional funds rolled to Fund Balance. As of 4/2/26, the County has received $86,817 more than budgeted in Directed Payment revenues for FY26. The State of NC (NCDHHS) invoices the County as a provider of the Managed Care Directed Payment program on a quarterly basis. Due to the timing of the invoices, funds received in FY25 are needed to pay invoices received in FY26.
North Carolina Medicaid and NC Health Choice programs have transitioned from a predominantly fee-for-service structure to a managed care health insurance model on July 1, 2021. For managed care Directed Payments, the funding mechanism shifts to an Intergovernmental Transfer (IGT) whereby the Public Ambulance Providers (PAP) will submit payment for the non-federal share of the difference between the gross cost-based rate and the historical level of Medicaid payment for interim claims by the Division.
POLICY IMPACT
N/A
ATTACHMENTS
Budget Change Request (BCR)