Archived Rules Actions

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The Department of Health and Human Services (NCDHHS) is authorized to adopt rules to implement the program. The Department proposes amending Rule 10A NCAC 23A .0102 to remove the definition of “Caretaker Relative” from the rule. This term is no longer used in any other rule and conflicts with the definition in the North Carolina Medicaid State Plan. 

The proposed effective date for both rules is March 1, 2022.

Amended 10A NCAC Chapter 23A .0102 to be submitted to RRC

Fiscal Note

No fiscal note was required by G.S. 150B-21.3A(d)(2) for the proposed amended Rule 10A NCAC 23A .0102. 

Public Hearing

Dec. 1, 2021 11:30 a.m.  

This remote hearing can be accessed by dialing 877-336-1839 and entering access code 3956100. 

 Public Hearing Minutes Final for Agency Site

Public Comments

Comments to Proposed Repeal of “Caretaker Relative” Definition

Procedure for Subjecting a Proposed Rule to Legislative Review

If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission after the adoption of the Rule. If the Rules Review Commission receives written and signed objections after the adoption of the Rule in accordance with G.S. 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in G.S. 150B-21.3(b1). The Commission will receive written objections until 5 p.m. on the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission. If you have any further questions concerning the submission of objections to the Commission, please call a Commission staff attorney at 919-431-3000. 
 

Notification of Proposed Adoption and Amendment of 10A NCAC 23A .0102

The Department of Health and Human Services (DHHS) is authorized to adopt rules to implement the program and to ensure beneficiary procedural rights during an appeal. Rule 10 NCAC 21A .0304 permits the Medicaid hearing officers to conduct appeal hearings by electronic means with the parties attending at the DSS office in order to streamline disposition, reduce staff time spent on travel, and offer alternative means of holding hearings in the event a local DSS office is closed due to emergency.

Pursuant to S.L. 2020-78 Section 4D.2, the Division of Health Benefits (DHB) must issue Medicaid identification cards to recipients on an annual basis and shall adopt or amend rules relating to Medicaid identification cards. Rule 10 NCAC 23B .0102 is the codification of the existing practice of issuing annual Medicaid ID cards.

The proposed effective date for both rules is Oct. 1, 2021.  

10A NCAC Chapter 21 and 23 Rules to be Submitted to the RRC

Fiscal Notes 

The following fiscal note for 21A .0304 was approved by OSBM on March 26, 2021. 

Subchapter 21A Fiscal Note: 10 NCAC 21A .0304  

The following revised fiscal note for 21A .0304 was approved by OSBM on Dec. 1, 2021.

Subchapter 21A Revised Fiscal Note: 10A NCAC 21A .0304

No fiscal note was required by G.S. 150B-21.3A(d)(2) for the following proposed rules: 

10 NCAC 23B .0102

Public Hearing

Thursday, June 17, 2021 at 10 a.m.

Public Hearing Minutes

 This Remote Hearing can be accessed by dialing (877) 336-1839 and entering access code 3956100.

Public Comments

You may submit comments from June 1, 2021 through Aug. 2, 2021, via email to MedicaidRulesComments@dhhs.nc.gov or by mail to the following:

Shazia Keller, DHB Rulemaking Coordinator
NC DHHS Division of Health Benefits
2501 Mail Service Center
Raleigh, NC 27699-2501
 

Procedure for subjecting a proposed rule to Legislative Review

If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission after the adoption of the Rule. If the Rules Review Commission receives written and signed objections after the adoption of the Rule in accordance with G.S. 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in G.S. 150B-21.3(b1). The Commission will receive written objections until 5:00 p.m. on the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission. If you have any further questions concerning the submission of objections to the Commission, please call a Commission staff attorney at 919-431-3000.
 

Notification of Proposed Adoption and Amendment of 10A NCAC Chapter 21 and 23 Rules

Notice of Proposed Rules  

NC Register Vol.35, Issue 23  

Pursuant to GS 150B-21.3A, Periodic review and expiration of existing rules, each agency shall conduct a review of its existing rules at least once every 10 years. As a result of this periodic review process, the North Carolina Department of Health and Human Services, Division of Health Benefits is readopting, repealing or amending 90 rules in 10A NCAC Chapters 21 and 22, Subchapters 21A, 21B, 21D, 22B, 22C, 22D, 22F, 22G, 22H, 22I, 22J, 22K, 22L, 22N, and 22O to ensure these rules reflect current law and processes. The proposed effective date is May 1, 2018.

10A NCAC Chapter 21 and 22 Rules Submitted to the RRC

10 NCAC 21A .0301; .0302; .0303

10 NCAC 21B .0204; .0311

10 NCAC 21D .0101-.0103; .0201; .0301-.0302; .0401-.0402; .0501-.0503

10 NCAC 22B .0101; .0102; .0103; .0104; .0105

10 NCAC 22C .0101 - .0103

10 NCAC 22D .0101

10 NCAC 22F .0104; .0105; .0106; .0107; .0201; .0202; .0203; .0301; .0302; .0401; .0402; .0601; .0602; .0603; .0604; .0605; .0606; .0704; .0706

10 NCAC 22G .0108; .0109; .0208; .0502; .0504; .0509

10 NCAC 22H .0101; .0102-.0103; .0104; .0105; .0201; .0202; .0203; .0204, .0205; .0301; .0302; .0303; .0304; .0305

10 NCAC 22I .0102; .0104

10 NCAC 22J .0102; .0103; .0104; .0105; .0106

10 NCAC 22K .0101; .0102; .0103

10 NCAC 22L .0101; .0102; .0103; .0104; .0201; .0203

10 NCAC 22N .0101; .0102; .0201; .0202; .0203; .0301; .0302-.0303

10 NCAC 22O .0112

Notification of Proposed Readoption, Amendment or Repeal of 10A NCAC Chapter 21 and 22 Rules

Public Comments

Public comments were collected Jan. 2, 2018 – March 5, 2018.

Public Hearing

There was a public hearing on Jan. 24, 2018,  from 1-3 p.m. at the Dorothea Dix Campus, Brown Building, Room 104, 801 Biggs Drive, Raleigh, NC 27603 (map). 

Fiscal Notes and Federal Law Certifications

The following fiscal note was approved by OSBM on Oct. 30, 2017. Proposed changes to 10A NCAC 22H .0205 and .0305 have an impact on local government. The federal law certification required by G.S. 150B-19.1(g) is located at the end of the fiscal note.

The following fiscal notes were approved by OSBM on Oct. 30, 2017, although no fiscal notes were required by G.S. 150B-21.4 or G.S. 150B-21.3A(d)(2). The federal law certifications required by G.S. 150B-19.1(g) are located, as applicable, at the end of each fiscal note. 

No fiscal note was required by G.S. 150B-21.3A(d)(2), but a federal law certification was required by G.S. 150B-19.1(g) for the following proposed rules:

No fiscal note was required by G.S. 150B-21.4 or G.S. 150B-21.3A(d)(2) and no federal law certification was required by G.S. 150B-19.1(g) for the following proposed rules:

  • Subchapter 21D: 10A NCAC 21D .0101, .0102, .0103, .0201, .0301, .0302, .0401, .0402, .0501. 0502, .0503
  • Subchapter 22C: 10A NCAC 22C .0101, .0102, .0103
  • Subchapter 22D 10A NCAC 22D .0101
  • Subchapter 22I: 10A NCAC 22I .0102, .0104
  • Subchapter 22O: 10A NCAC 22O .0112

Rules Proposed for Readoption with substantive changes (published on 1/2/18 in the NC Register) 

Rules Proposed for Readoption without substantive changes (not published in the NC Register) 

Rules Proposed for Amendment (published on 1/2/18 in the NC Register) 

Rules Proposed for Repeal (published on 1/2/18 in the NC Register) 

Procedure for Subjecting a Proposed Rule to Legislative Review

If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission. If the Rules Review Commission receives written and signed objections in accordance with G.S. 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in G.S. 150B-21.3(b1). The Commission will receive written objections until 5:00 p.m. on the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission. If you have any further questions concerning the submission of objections to the Commission, please call a Commission staff attorney at 919-431-3000.

Pursuant to GS 150B-21.3A (Periodic review and expiration of existing rules), each agency shall conduct a review of its existing rules at least once every 10 years. As a result of this periodic review process, the North Carolina Department of Health and Human Services, Division of Health Benefits is readopting, repealing, or amending 47 rules in 10A NCAC Chapters 23 and 25, Subchapters 23A, 23C, 23D, 23E, 23G, 23H, 25A, 25H, 25K, 25M, and 25P, to ensure these rules reflect current law and processes. The proposed effective date is May 1, 2019.  

Periodic Review and Expiration of Existing Rules Project
10 NCAC Chapter 23 and 25 Rules Submitted to the RRC
Notification of Proposed Readoption, Amendment or Repeal
Public Comments/Public Hearing
Fiscal Notes and Federal Law Certifications
Readoption of 10A NCAC 22F .0301
 

10 NCAC Chapter 23 and 25 Rules Submitted to the RRC

10A NCAC 23A .0103

10A NCAC 23C .0201

10A NCAC 23D .0101; .0102; .0201

10A NCAC 23E .0101; .0102; .0103; .0104; .0105; .0106; .0107; .0108; .0201; .0202; .0203; .0204; .0205; .0206; .0207; .0208; .0209; .0210; .0211

10A NCAC 23G .0101; .0201; .0202; .0203; .0204; .0303; .0304

10A NCAC 23H .0106; .0107; .0108; .0109; .0110; .0111; .0112; .0113

10A NCAC 25A .0201

10A NCAC 25H .0203

10A NCAC 25K .0201; .0401

10A NCAC 25M .0201

10A NCAC 25P .0201; .0301; .0402

Notification of Proposed Readoption, Amendment or Repeal of 10A NCAC Chapter 23 and 25 Rules

Public Comments

Public comments may be submitted January 2, 2019 - March 4, 2019.  

You may submit comments by email to MedicaidRulesComments@dhhs.nc.gov or by mail to the following:

Ryan Eppenberger, DHB Rulemaking Coordinator
NC DHHS Division of Health Benefits
2501 Mail Service Center, Raleigh, NC 27699-2501

Public Hearing

There was a public hearing on Jan. 25, 2019, from 1-3 p.m. at the Dorothea Dix Campus, Brown Building, Room 104, 801 Biggs Drive, Raleigh, NC 27603

Fiscal Notes and Federal Law Certifications

The following fiscal notes were approved by OSBM on December 3, 2018. The federal law certifications required by G.S. 150B-19.1(g) are located, as applicable, at the end of each fiscal note.

•   Subchapter 23A Fiscal Note and Federal Law Certification: 10A NCAC 23A .0103

•    Subchapter 23C Fiscal Note and Federal Law Certification: 10A NCAC 23C .0201 

•    Subchapter 23E Fiscal Note and Federal Law Certification: 10A NCAC 23E .0101, .0102,
     .0103, .0104, .0105, .0106, .0107, .0108, .0201, .0202, .0203, .0204, .0205, .0206, .0207,
     .0208, .0209, .0210, .0211

•    Subchapter 23E Fiscal Note on NC OSBM website

•    Subchapter 23G Fiscal Note and Federal Law Certification: 10A NCAC 23G .0101, .0201,
     .0202, .0203, .0204, .0303, .0304

No fiscal note was required by G.S. 150B-21.3A(d)(2), but a federal law certification was required by G.S. 150B-19.1(g) for the following proposed rules: 

•    Subchapter 23H Federal Law Certification: 10A NCAC 23H .0106, .0107, .0108, .0109,
     .0110, .0111, .0112, .0113

•    Subchapter 25A Federal Law Certification: 10A NCAC 25A .0201

•    Subchapter 25K Federal Law Certification:10 A NCAC 25K .0401

Note: Links to the text of the below-mentioned rules can be found above.

No fiscal note was required by G.S. 150B-21.4 or G.S. 150B-21.3A(d)(2) and no federal law certification was required by G.S. 150B-19.1(g) for the following proposed rules: 

•    Subchapter 23D: 10A NCAC 23D .0101, .0102, .0201
•    Subchapter 25H: 10A NCAC 25H .0203
•    Subchapter 25K: 10A NCAC 25K .0201
•    Subchapter 25M: 10A NCAC 25M .0201
•    Subchapter 25P: 10A NCAC 25P .0201, .0301, .0402

Rules Proposed for Readoption with Substantive Changes Published on 1/2/19 in the NC Register:

10A NCAC 23A .0103
10A NCAC 23C .0201
10A NCAC 23D .0101, .0102, and .0201
10A NCAC 23E .0101, .0102, .0103, .0104, .0107, .0108, .0201, .0202, .0203, .0204, .0205, .0206, .0207, and .0208
10A NCAC 23G .0101, .0204, and .0303
10A NCAC 25K .0201
10A NCAC 25M .0201
10A NCAC 25P .0201, .0301, and .0402

Rules Proposed for Readoption Without Substantive Changes (not published in the NC Register):

10A NCAC 23E .0105, .0106, .0209, .0210, and .0211
10A NCAC 23G .0201, .0202, .0203, and .0304
10A NCAC 23H .0106, .0107, .0108, .0109, .0110, .0111, .0112 and .0113
10A NCAC 25A .0201
10A NCAC 25H .0203
10A NCAC 25K .0401

Readoption of 10A NCAC 22F .0301

Notice is hereby given in accordance with G.S. 150B-21.12(c) that the Department of Health and Human Services, Division of Health Benefits intends to readopt with substantive changes the rule cited as 10A NCAC 22F .0301.

Reason for Agency Action: This Rule was objected to by the RRC at the June 14, 2018, August 16, 2018, and September 20, 2018 meetings. At its November 15, 2018 meeting, this Rule was approved by the RRC, but the RRC found that the rewritten rule submitted in respons to their objection resulted in substantial changes to the Rule as referenced in 150B-21.12(c). As such, this Rule must be "published and reviewed in accordance with the procedure set forth in G.S. 150B-21.1(a3) and (b)."

The Notice is posted on the OAH website: https://www.ncoah.com/rules/10A%20NCAC%2022F%20.0301%20with%20substantial%20changes.pdf

There was a public hearing on Jan. 25, 2019, from 1-3 p.m. at the Dorothea Dix Campus, Brown Building, Room 104, 801 Biggs Drive, Raleigh, NC 27603

Notice of Temporary Rulemaking

Pursuant to G.S. 143C-9-9, DHHS is creating the Rules in new Subchapters 10A NCAC 22Q and 22R to effectuate the directive from the General Assembly for the Department to create rules to implement G.S. 143C-9-9 (“Hospital Uncompensated Care Fund”). The purpose of these rules is to establish a sequence of distributions, define hospitals eligible to receive funding, define hospital costs eligible for reimbursement from the fund, and supply a formula for calculation of reimbursement of eligible hospitals’ eligible costs. The process for certifying DSH and calculating distribution of those funds to qualifying hospitals is essential for ensuring maximum receipt of federal Medicaid funds. Temporary enactment of these rules will enable prompt delivery of fiscal support to hospitals throughout the State.

The proposed effective date for these two new Subchapters and Rules is Dec. 29, 2021.  

10A NCAC Chapter 22 Rules to Be Submitted to the RRC

Fiscal Notes 

No fiscal note was required for the proposed temporary rules in Subchapters 22Q and 22R.

Public Hearing 

Wednesday, Nov. 4, 2021: Minutes  

Public Comments

You may submit comments from Oct 27, 2021 through Nov 22, 2021, via email to MedicaidRulesComments@dhhs.nc.gov or by mail to the following:

Shazia Keller, DHB Rulemaking Coordinator
NC DHHS Division of Health Benefits
2501 Mail Service Center
Raleigh, NC 27699-2501

Procedure for subjecting a proposed rule to Legislative Review

If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission after the adoption of the Rule. If the Rules Review Commission receives written and signed objections after the adoption of the Rule in accordance with G.S. 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in G.S. 150B-21.3(b1). The Commission will receive written objections until 5:00 p.m. on the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission. If you have any further questions concerning the submission of objections to the Commission, please call a Commission staff attorney at 919-431-3000.

Notification of Proposed Temporary Rules 10A NCAC 22 Subchapters Q and R.

Notice of Emergency Rulemaking Emergency and Proposed Temporary Rule 10A NCAC 21A .0304

Proposed Temporary Rule 10A NCAC 21A .0304 was amended in response to public comments before filing. It will be considered for approval by the Rules Review Commission on June 18, 2020, at 9 a.m. 

Public Hearing: May 20, 2020, from 10 a.m. to noon. Public hearing minutes. 

On May 1, 2020, the notice for the proposed temporary rulemaking was posted on the OAH website.

Comment Period: April 24-2020, to May 22, 2020

Written Comment to Rule 21A.0304 

Submit comments via by email to MedicaidRulesComments@dhhs.nc.gov or in writing to:

Shazia A. Keller, DHB Rulemaking Coordinator
NC DHHS Division of Health Benefits
2501 Mail Service Center
Raleigh, NC 27699-2501
 

Procedure for Subjecting a Proposed Rule to Legislative Review

If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission. If the Rules Review Commission receives written and signed objections in accordance with G.S. 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in G.S. 150B-21.3(b1). The Commission will receive written objections until 5:00 p.m. on the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission. If you have any further questions concerning the submission of objections to the Commission, please call a Commission staff attorney at 919-431-3000.

Notice of Permanent Rulemaking 

The Department of Health and Human Services (DHHS) is authorized to adopt rules to implement the NC Medicaid program. The Rules in new Subchapters 10A NCAC 22Q and 22R will effectuate the directive from the General Assembly for the Department to create rules to implement G.S. 143C-9-9 ("Hospital Uncompensated Care Fund"). The purpose of these rules is to establish the sequence of allocations of federal disproportionate share adjustment receipts arising from certified public expenditures, define the hospitals eligible for participation in the distribution of these funds, and codify formulas for calculating the distributions using outpatient cost metrics. Most supplemental payments are not permitted in managed care, which launched on July 1, 2021. The process for certifying DSH and calculating distribution of those funds to qualifying hospitals is essential for ensuring maximum receipt of federal Medicaid funds. In accordance with G.S. 15B-21.1(d)(2), these permanent rules will replace substantively identical temporary rules that became effective December 29, 2021.  

The proposed effective date for these two new Subchapters and Rules is July 1, 2022.  

10A NCAC Chapter 22 Rules to Be Submitted to the RRC

Fiscal Note

The following fiscal note for Subchapters 22Q and 22R was approved by the Office of State Budget and Management (OSBM) on February 4, 2022.  

Public Hearing

Thursday, March 31, 2022 at 10:00 a.m.  
This Remote Hearing can be accessed by dialing 877-336-1839 and entering access code 3956100.

Public Comments

You may submit comments from March 15, 2022, through May 17, 2022, via email to MedicaidRulesComments@dhhs.nc.gov or by mail to the following:

Shazia Keller, DHB Rulemaking Coordinator
NC DHHS Division of Health Benefits
2501 Mail Service Center
Raleigh, NC 27699-2501

Procedure for Subjecting a Proposed Rule to Legislative Review

If an objection is not resolved prior to the adoption of the rule, a person may also submit written objections to the Rules Review Commission after the adoption of the Rule. If the Rules Review Commission receives written and signed objections after the adoption of the Rule in accordance with G.S. 150B-21.3(b2) from 10 or more persons clearly requesting review by the legislature and the Rules Review Commission approves the rule, the rule will become effective as provided in G.S. 150B-21.3(b1). The Commission will receive written objections until 5:00 p.m. on the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission. If you have any further questions concerning the submission of objections to the Commission, please call a Commission staff attorney at 919-431-3000.

Notification of Proposed Adoption of 10A NCAC 22 Subchapters Q and R.

Notice of Proposed Rules 

NC Register Vol. 36, Issue 18

This page was last modified on 05/19/2023