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North Carolina Medicaid agency: Positive cash balance at end of 2nd consecutive fiscal year

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RALEIGH, North Carolina — North Carolina's Medicaid agency said Tuesday that it had good financial news at the close of the second consecutive fiscal year, again registering a positive cash balance.

The leftover funds may help Gov. Pat McCrory's administration in General Assembly negotiations over whether his agency should retain oversight of the massive health care program.

The Division of Medical Assistance said Medicaid had $130.7 million in cash available June 30, more than twice the $64 million cash balance registered June 30, 2014. The division contrasts the positive balance with the need for hundreds of millions in additional dollars beyond what was budgeted to cover claims annually from 2010 to 2013.

Dave Richard, a state deputy secretary for Medicaid, said the positive balance reflects better spending forecasts and a good working relationship with the General Assembly, which funds the state's share of Medicaid. An outside contractor helped develop the forecasts. What's left over gets returned to state coffers.

North Carolina Medicaid spends more than $13 billion annually on caring for up to 1.8 million people, largely poor children, older adults and the disabled. The state pays about one-fourth of that.

"The year went very well for Medicaid," Richard told The Associated Press. "We're really thrilled."

In addition to spending more on Medicaid to cover recurring medical claims, the legislature also provided $136.5 million in one-time funds last year to cover previously unbudgeted items, unpaid claims and paying for people waiting to be enrolled in Medicaid.

Cash balances don't account for anticipated billings by doctors, hospitals and other providers for services performed last year but have yet to be turned in. The estimated billings are expected in a couple weeks, but Richard said there's nothing to indicate those claim levels will be out of what is ordinarily expected.

A more detailed Medicaid audit released in April by State Auditor Beth Wood also showed financial improvement but calculated the agency's fund balance — basically assets minus liabilities — at negative $350 million as of last June 30. Hundreds of millions of dollars in yet-paid claims were blamed for a great deal of that negative balance.

State Medicaid leaders said that audit considers some pending items differently and doesn't diminish the positive year-end numbers.

"North Carolina's Medicaid budget is in far better shape, but there is still more work to be done to implement a long-term solution for our Medicaid program," McCrory said in a news release.

House and Senate Republicans still meeting this summer remain at odds over how to pay for Medicaid services going forward and who should oversee the program.

Senate Republicans want to put Medicaid in the hands of a new "benefits authority," and out of the Department of Health and Human Services, which includes the Division of Medical Assistance. House counterparts and McCrory, also a Republican, want DHHS to remain in control of Medicaid.

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