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SB 464

An Act amending Title 42 (Judiciary and Judicial Procedure) of the Pennsylvania Consolidated Statutes, in sentencing, further providing for definitions and for sentencing procedure for murder of the first degree.

2025-2026 Regular Session Introduced by Tracy Pennycuick and 2 co-sponsors

SB 464 suspends Medicaid during incarceration (not terminate) to preserve continuity of SUD treatment, while creating a team-based Medicaid care model and MOUD access.

Referred to Judiciary
0
WeVote Research Nonpartisan
Bill Summary · SB 464

SB 464 — Inmate Medicaid Suspension / Team-Based Care (Summary)

Status: Passed 1st Reading. Introduced: Feb 19, 2025. Subject areas: Medicaid, corrections, substance use treatment, public health.

Main purpose

SB 464 directs North Carolina’s Department of Health and Human Services (DHHS), Division of Health Benefits (DHB), to (1) create a new, team‑based Medicaid service for treatment of substance use disorders (SUDs) and (2) change state Medicaid policy so coverage is suspended — not terminated — when a beneficiary is incarcerated, in order to preserve continuity of care on release.

Key provisions

  • Team‑based Medicaid service

    • DHB must develop a Medicaid care‑coordination service for substance use care (via a DHB‑convened stakeholder working group). Minimum components required:
    • Screening for alcohol use disorder, opioid use disorder, and other mild-to-moderate SUDs
    • Access to prescription medications for opioid use disorder (MOUD) and medications for alcohol use disorder
    • Recovery support services
    • Case management / care coordination
    • DHB must report to the Joint Legislative Oversight Committee on Medicaid and the Fiscal Research Division by October 1, 2025, with: the State share of cost, intended start date, and which Prepaid Health Plan (PHP) capitated contracts (and any proposed statutory changes) will cover the service.

  • Provider education and workforce development

    • DHB must develop a statewide campaign to: educate providers and community leaders about Medicaid changes; train interested clinicians in SUD clinical care; and encourage SUD provider participation in Medicaid.

  • Medicaid suspension on incarceration

    • To comply with the federal Consolidated Appropriations Act, 2024 (Pub. L. 118‑42), DHB must update Medicaid policy and the State Plan as necessary so Medicaid eligibility is suspended (not terminated) during incarceration.
    • DHHS and the Department of Adult Corrections must enter a memorandum of understanding (MOU) to share eligibility data for people entering or released from jails, and the Department of Adult Corrections must update policies and manuals to implement the change. The bill enables implementation potentially as early as July 1, 2025.

  • Effective date: when the act becomes law.

Who would be affected

  • Medicaid beneficiaries who become incarcerated — their coverage would be suspended rather than terminated, reducing administrative disruption and facilitating rapid reactivation on release.
  • People with SUDs — increased access to coordinated Medicaid‑funded treatment, MOUD, recovery supports, and case management.
  • State agencies — DHHS/DHB and Department of Adult Corrections (data‑sharing, policy and IT changes).
  • Medicaid managed care plans (PHPs), SUD treatment providers, jails/corrections facilities, and county/local health partners.
  • Fiscal impact: not specified in the text; DHB must include the State share of costs in its Oct. 1, 2025 report. Implementation will require administrative and programmatic resources and possible Medicaid expenditure increases (potential federal match may apply).

Timeline / procedural notes

  • DHB stakeholder working group: to be established by DHB (no specific deadline in text).
  • Report due to legislature: October 1, 2025 (must include cost and start date proposals).
  • Policy updates and MOU between DHHS and Department of Adult Corrections intended to enable compliance with federal law — potentially effective as early as July 1, 2025.
  • Bill effective upon becoming law.

Compiled from official sources — confirm details with the bill’s official record.

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