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Based on legislative mandate, the Department of Health and Human Services, Division of Medical Assistance, and the North Carolina State Health Plan formed a joint work group to study the NC Health Choice benefit plan and its administration and make recommendations to the program in light of the phase-out of the Comprehensive Major Medical Plan for Teachers and State Employees, also referred to as “CMM” or the “Indemnity plan” effective July 1, 2008.  The legislation was enacted to help ensure NC Health Choice, which is benchmarked to the CMM by state law (i.e. Health Choice coverage is required to be substantially equal to coverage provided to dependents of teachers and state employees), does not experience a disruption in access to care, quality of medical care services, or claims processing as a result of the phase out of the Indemnity plan offered to State Health Plan members.  The report is entitled, “STATE CHILDREN’S HEALTH INSURANCE PROGRAM ADMINISTRATION (NC HEALTH CHOICE PROGRAM FOR CHILDREN) Joint Report of the Department of Health and Human Services, Division of Medical Assistance and the North Carolina State Health Plan to the North Carolina General Assembly, Legislative Committee on Employee Hospital and Medical Benefits.”  To review the report or print a copy of the pdf, please click here (668 KB).
           
The requirements of the study, specified in Section 28.22(j) of S.L. 2007-232, are as follows:

“To ensure a smooth and effective transition of the administration of the NC Health Choice Program, enacted under Part 8 of Article 2 of Chapter 108A of the General Statutes, and administered under Part 5 of Article 3 of Chapter 135 of the General Statutes, the Executive Administrator of the Teachers’ and State Employees’ Comprehensive Major Medical Plan and the Department of Health and Human Services, Division of Medical Assistance, shall meet to discuss the administration of NC Health Choice in view of the implementation of the State Health Plan for Teachers and State Employees effective July 1, 2008.  These meetings shall address all issues that may arise regarding the administration of NC Health Choice under the State Health Plan, including provider payment rates and collection of applicable premiums and copayments.  The Executive Administrator and the Department shall report to the Committee on Employee Hospital and Medical Benefits not later than February 1, 2008, with recommendations on statutory or other changes necessary to ensure effective administration of NC Health Choice.”