Sen. Burgin files bill in North Carolina Senate to expand Medicaid plan options

A new bill filed by State Sen. Jim Burgin seeks to increase Medicaid beneficiaries’ options and improve continuity of care within the North Carolina healthcare system, according to the North Carolina State Senate.

The bill, filed as SB 466 on March 24 during the 2025 regular session, was formally listed with the short title: ‘Ensure Continuity of Care in Tailored Plans.’

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, this bill mandates that by July 1, 2025, the North Carolina Department of Health and Human Services submit necessary amendments to the Centers for Medicare and Medicaid Services to allow more flexibility for beneficiaries of BH IDD Tailored Plans. Specifically, beneficiaries can choose to remain in the Medicaid fee-for-service program, called Medicaid Direct, if their healthcare providers are not part of the LME/MCO Tailored Plan network, to ensure continuity of care. Additionally, it permits beneficiaries to select a BH IDD tailored plan outside their residing region based on service variety, available services, or provider networks. By August 1, 2025, the department must report to the Joint Legislative Oversight Committee on Medicaid with strategies to enhance competition among local managed care organizations, promote innovation, and improve care for Medicaid beneficiaries, including necessary state plan amendments and recommendations for legislative changes. The act becomes effective upon becoming law.

Of the two sponsors of this bill, Lisa Grafstein proposed the most bills (45) during the 2025 regular session.

Bills in North Carolina follow a multi-step process before becoming law. A lawmaker starts by filing a bill, which is assigned to a committee for review. The bill must be read three times in each chamber. If one chamber changes the bill after the other passes it, both must agree on the final version. Once both chambers approve the same bill, it goes to the governor, who has 10 days (or 30 if the legislature is not in session) to sign, veto, or let it become law without a signature.

You can read more about the bills and other measures here.

Burgin graduated from The University of Tennessee Knoxville with a BS.

Burgin, a Republican, was elected to the North Carolina State Senate in 2019 to represent the state’s 12th Senate district, replacing previous state senator Ronald Rabin.