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In the spirit of keeping things simple, the case for reforming North Carolina’s medical-assistance programs can be expressed in four numbers: 12, 15, 17, and 48,'' writes John Hood in his weekly column/blog for the John Locke Foundation.

These are all national rankings. North Carolina ranks 12th in the nation in state mental health spending per capita. North Carolina ranks 15th in Medicaid payments per child or working-aged adult enrolled in the program. North Carolina ranks 17th in state and local taxes as a percentage of personal income. And North Carolina ranks 48th in per-pupil spending on elementary and secondary schools.

The state Department of Health and Human Services' testing program for the new Medicaid billing system was seriously flawed, a report from State Auditor Beth Wood's office said.

The state is preparing to launch a new, expensive, and long-delayed Medicaid billing software on July 1. DHHS did not have adequate tests and evaluations in place to make sure the system, which DHHS calls NCTracks, is ready, the audit says.

In its response, DHHS agreed with the recommendations and is acting on them.

Even though DHHS was moving to plug holes in its preparations, the audit includes an ominous warning.

"The complexity of the NCTracks system makes it impossible to predict all of the scenarios that could impact the project, even after it is tested in accordance with industry best practices."

In other words, providers should expect things to go wrong.

UPDATED: DEMOCRATIC PARTY'S PROBLEMS GROW: The head of the North Carolina Democratic Party is facing questions about credit card charges made during a March trip to a Las Vegas casino to watch basketball games with his old college buddies. Records obtained by The Associated Press show state Democratic Chairman Randy Voller made $3,327 in charges to Southwest Airlines and the Wynn Las Vegas Hotel on an American Express Business Gold Card embossed with his name and that of the North Carolina Democratic Party. He said he's paid off the balance in full. Much more to this story -- click here.

N.C. LAWMAKERS TO PLAY "THE OTHER CAROLINA" IN BASKETBALL: North Carolina lawmakers will challenge their South Carolina counterparts to a game of hoops Wednesday evening at Reynolds Coliseum. The game is the first in at least four years between lawmakers from the two Carolinas. Rep. Burt Jones, a Rockingham Republican who will coach the North Carolina squad, helped revive the tradition. “The games in the past were pretty competitive,” he said. (Scouting report below.)

***This is the Dome Morning Memo -- the source for N.C. political news and fun (see below). Send news and tips to dome@newsobserver.com. ***

NEARLY HALF VOTERS CONSIDER SAY #NCGA CAUSING NATIONAL EMBARRASSMENT: One of the more intriguing poll numbers in the latest monthly Public Policy Polling survey due out later today: 45 percent. That's the portion of voters who believe the N.C. General Assembly is causing the state "national embarrassment." The poll question comes after a number of hot-button legislative issues received national attention -- and ridicule. Another 31 percent don't think the state legislature is a blemish and another 24 percent are undecided. (More from poll below.)

TODAY AT THE STATEHOUSE: No rest for the weary this week on Jones Street. The Senate appropriations committee meets at 8:30 to discuss its $20.6 billion state budget. Democrats will raise objections but no significant changes are expected. At the same time, the House Finance Committee will consider a major immigration bill that is drawing increasing fire from the ACLU and others concerned about Arizona-type provisions about stopping and detaining people who did not enter the country legally. At 11 a.m., the House Education Committee will get its first look at a new private school voucher bill. Senate and House floor calendars are light after crossover week's flurry, but the House will give final reading to a bill limiting tolling of existing highways.

Gov. Pat McCrory will meet with the Philippine ambassador at 8:45 a.m. in a private meeting and later attend a N.C. Department of Transportation luncheon. McCrory will speak to a group of under-45 CEOs as part of the southern chapter of the Young Presidents' Organization conference and travel to Charlotte this evening for a forum with the city's other current and former mayors.

***This is the Dome Morning Memo. Read more new exclusive PPP numbers below and get more insights into the state budget. ***

The top three Republican politicians in the state announced Friday they are all together when it comes to Medicaid reform.

Gov. Pat McCrory, Senate Leader Phil Berger and House Speaker Thom Tillis sent out a joint news release emphasizing that – despite criticism of the move toward privatization – the state is proceeding with plans to reign in costs in the $13 billion program.

Their joint announcement said the state Senate’s budget will require the state Department of Health and Human Services submit a waiver application to the federal government. The budget, which will be released Sunday evening, will have to be approved by both chambers in the General Assembly.

A federal waiver would allow the state flexibility in operating and paying for its Medicaid programs. McCrory has said he wants to privatize some of Medicaid as a way to reduce cost overruns.

Guiding principles in the state’s reform plan include focusing on behavior as a way to improve health, making it easier on providers, and developing a reliable estimate of costs.

On Thursday, the House approved spending $400 million through next month to close the current shortfall and repay the federal government other debts.

TODAY AT THE STATEHOUSE: As the final two days of the self-imposed crossover deadline begin, it's crunch time. You can tell from the lobbyists working the halls, either trying to get a bill to move or asking committee chairman to "pray on it" for a little while longer. And the controversial bills are coming the surface. A House committee will consider a bill to extend "protections of conscience" to more medical professionals and cover more things, such as providing contraception. In the same committee, another measure dubbed the "Religious Freedom Restoration Act" is sure to recall attempts earlier this session to declare the state's ability to establish an official religion.

The full House - which convenes near 2 p.m. -- will also consider a bill to soften rules on where local governments must post public notices. A controversial amendment would tell newspapers how much they could charge for such advertisements. The Senate this afternoon will consider measures to amend environmental regulations and repeal local smoking bans. Gov. Pat McCrory is spending another day in New Orleans at a Republican Governor's Association event.

WOS ROADSHOW CONTINUES: A week after a major gaffe by Health and Human Services Secretary Aldona Wos, her statewide tour to tout Medicaid reforms continues. She visits Durham on Wednesday where she will encounter members of the Medical Professionals for Expanded Health Access who expect to question her about the state's decision to reject a Medicaid expansion. Wos blamed Democratic Insurance Commissioner Wayne Goodwin for the decision -- even though it was ultimately made by her boss, Gov. Pat McCrory. The event starts at 4 p.m.

***Thanks for reading the Dome Morning Memo -- a roundup of North Carolina political news and notes. Send tips to dome@newsobserver.com.***

Aldona Wos, head of the state Department of Health and Human Services, gave a strange and inaccurate response when challenged on the decision not to expand Medicaid, North Carolina Health News reports.

Wos was speaking in Reidsville, one of the stops on a tour to sell a managed care plan for Medicaid.

When challenged by a doctor on the decision not to expand the government health insurance to about 500,000 working-class people, Wos said state Insurance Commissioner Wayne Goodwin made the decision.

Um, no.

That decision came from the legislature and Gov. Pat McCrory, who hired Wos.

UPDATE: Ricky Diaz, communications director for DHHS, explains:

“The Secretary was talking broadly about the Insurance Commissioner’s oversight authority over the health care insurance industry in North Carolina, and it is unfortunate that her remarks were taken out of context.”

UPDATE: On Saturday evening, North Carolina Health News posted an audio of Wos' remarks. Judge for yourself.

Gov. Pat McCrory's administration is warning that the state health care program for the poor will cost $135 million more than anticipated.

The cost overruns for Medicaid now total $248 million. The state Department of Health and Human Services blamed former Democratic Gov. Bev Perdue's administration for the "forecasting error" in estimating federal dollars coming to the state.

Doctors' groups don't like Gov. Pat McCrory's proposal to have managed care organizations run Medicaid. The N.C. Academy of Family Physicians hopes patients agree.

The Academy has put up a website and petition about McCrory's Medicaid proposal that asks the administration to involve family doctors in talks on how to change Medicaid, the government insurance program for the poor, elderly and disabled.

McCrory has proposed that the state put the state's $13 billion a year Medicaid business out to bid, opening the program to management by managed care companies. Under the proposal, two to four organizations would offer health plans and be paid a set amount of money for each patient enrolled.

Doctors prefer the system the state has built, called Community Care North Carolina, which helps patients manage chronic diseases such as asthma, and seeks to keep them getting so sick that the go to emergency rooms. Unlike the managed care system McCrory proposes, doctors and hospitals are paid for each Medicaid service.

***Good morning, and TGIF. Welcome to Dome Morning Memo, a look at the day ahead and a roundup of the news you might have missed Wednesday.