Cost-Savings and Cost-Recovery Programs

Cost-Recovery Programs

Debt Setoff

Local Government Delinquent Debt Setoff Program

The North Carolina Association of County Commissioners (NCACC) and the North Carolina League of Municipalities (NCLM) sponsor a debt setoff joint clearinghouse through which local governments may submit any outstanding delinquent debt (totaling $50 or more) through the clearinghouse to the North Carolina Department of Revenue to attempt to offset delinquent debts against individual state income tax refunds or winnings from the North Carolina Education Lottery.

The program, authorized by the General Assembly and administered by Five Star Computing in Columbia, South Carolina, offers another collection method for outstanding debts to counties, cities and other local agencies, such as water and sewer authorities, joint regional agencies, public health authorities and sanitary districts.

Technical Assistance

Please visit to find resources and training materials related to the Debt Setoff program.

EMS Medicaid Cost Settlement

This program is an annual cost reporting program that allows for reimbursement of a portion of a participating units annual operational cost as they relate to Medicaid eligible emergency ambulance services. The North Carolina Association of County Commissioners (NCACC) administers this program in conjunction with the NC Department of Health and Human Services (DHHS) for units of government that deliver EMS services. Units of government must meet specific criteria in order to participate in the settlement program. The unit of government must first be enrolled as a NC Medicaid provider. The unit must also be a governmental unit as described in G.S. 138 A-3 (15d) of the state statue and have certified public expenditures (CPE) in order to be eligible for cost settlement. EMS Medicaid cost settlement is for governmental providers of emergency ambulance services only. Units of government that deliver these EMS services, or deliver those services through special arrangements with volunteers or private contractors, could be eligible to participate in the program.