- Associated Press - Thursday, May 8, 2014

RALEIGH, N.C. (AP) - Gov. Pat McCrory and budget-writers may have to wait until next year for lawmakers to rework the way North Carolina’s Medicaid program pays billions of dollars to doctors and hospitals for patient care, the Senate’s top leader said Thursday.

Speaking six days before the start of the legislative session, Sen. Phil Berger said he doesn’t know if consensus on a Medicaid overhaul can be reached in the short budget-adjustment session that traditionally ends by mid-July.

McCrory’s administration proposed in March to develop networks of primary care physicians or hospitals, building in financial incentives to keep costs down and requiring the health care providers to share in cost overruns.

North Carolina health care providers generally support the concept of “accountable care organizations.” But some senators aren’t sold that the idea will generate the kind of savings needed to rein in repeated shortfalls. McCrory said $500 million in unplanned Medicaid spending last year prevented teacher and state employee pay raises. Medicaid spends $13 billion in state and federal funds covering 1.6 million people.

“I am concerned that the proposal that was advanced doesn’t go far enough to help us with ensuring that Medicaid is not a continuing drain on other parts of our budget,” Berger, R-Rockingham, told reporters.

McCrory’s office didn’t immediately respond to an email seeking comment. Speaker Thom Tillis, R-Mecklenburg, said any Medicaid overhaul is part of a broader multiyear process to make Medicaid more efficiently that begun with a new billing system last year.

“Like tax reform, it needs to be taken in steps,” Tillis said in an interview with The Associated Press.

Berger and Tillis also said separately they expect the legislature will offer more pay raises to teachers and state employees beyond previously announced increases for early-career teachers. That’s in keeping with McCrory’s announcement Wednesday proposing an average 2 percent pay raise for veteran teachers and $1,000 flat raises for state workers.

But neither legislative leader committed immediately to those figures or to McCrory’s long term proposal for teacher pay. Berger said he liked the concept from McCrory of consolidating the teacher pay schedule so instructors can earn higher salaries more quickly.

Berger said he doesn’t know what final legislation will look like on the cleanup up coal ash ponds following the Dan River spill in February, but Tillis says it can be fully addressed this year. Berger, who lives in Eden near the spill site, said the Senate will begin with McCrory’s proposal released last month for improving oversight of the dumps.

“We need to have a solution that ensures that coal ash is not going to be a potential problem for our drinking water supplies,” Berger said. “That’s where we need to get to, and I think everybody wants to get to that place.”



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