SB 615 – Direct Care Worker Wage Passthrough/Medicaid

Primary Senate Sponsors: Sen. Natalie Murdock (D-Durham); Sen. Wiley Nickel (D-Wake); Sen. Julie Mayfield (D-Buncombe)


This bill:

  • Requires the Division of Health Benefits to provide a 15% rate increase option for personal care services reimbursed under specified Medicaid Clinical Coverage Policies.
  • Requires the Division to adjust the PMPM capitation amount paid to LME/MCOs operating capitated contracts for mental health, intellectual and developmental disabilities, and substance abuse services and to prepaid health plans.
  • Appropriates $9.3M in recurring funds for the 2021-2022 fiscal year and $21.85M in recurring funds for the 2022-2023 fiscal year to be used to implement the rate increase option.
  • Provides a process for the Division to recoup funds related to the rate increase option received by the provider if the Division determines that the provider did not use the funding from the rate increase to increase wages of all direct care professionals it employs to an hourly wage of no less than $15 or that the provider failed to track and report the use of the funding as required.


Filed – 4/6/2021