August 12, 2019Donald Pocock Appointed Chair of ABA Consumer Litigation Committee
February 15, 2019
NC Department of Health and Human Services Secretary Mandy Cohen appeared before the NC House Health Policy Committee on Tuesday to provide an update on the state’s transition to a privatized Medicaid system. Also referred to as Medicaid managed care, the legislation mandating that Medicaid be handed over to insurers became state law back in 2015. Last week, DHHS officially announced the five health insurers selected to take over the state’s Medicaid health program. Four statewide contracts, and one regional, were awarded following a rigorous RFP procurement process. AmeriHealth Caritas, Blue Cross and Blue Shield, UnitedHealthcare, and WellCare received statewide contracts, while the sole regional award went to Carolina Complete Health. In her remarks to the committee, Cohen said challenges to the contract awards are expected, specifically in the case of Aetna whose proposal was only 2.06 points below a contract winner. My Health by Health Providers, a Morrisville-based consortium of 12 NC hospitals did not receive a contract and has already announced plans for an appeal. The Secretary went on to say that the Department will move forward with the transformation effort and that appeals will be handled internally by DHHS staff, though they could potentially end up in court. [see attached article]
A number of bills have been filed the past two weeks in the House and Senate by both Republicans and Democrats, calling for school calendar flexibility. The legislation, short titled “School Calendar Flexibility/Certain School Systems,” would provide additional flexibility to certain local Boards of Education in adopting their respective school calendars. As of today, there are 10 local bills filed that would reinstate flexibility of school calendars to the local boards, a control that was taken away by the state in 2004. County Boards of Commission are passing resolutions as a show of solidarity and support for the effort. Additional local bills related to school calendar flexibility are expected to be filed in coming days. https://www.the-dispatch.com/news/20190212/county-approves-resolution-in-support-of-school-calendar-flexibility
A bill was introduced in the House this week that, if passed, will extend the deadline by which certain providers are required to connect to and participate in NC’s Health Information Exchange (HIE) network known as NC HealthConnex. Representatives Dobson, White, Murphy and Lambeth are the primary sponsors of HB70, “Delay NC HealthConnex for Certain Providers.” Providers of Medicaid services with an electronic health record system were to begin submitting demographic and clinical data to HealthConnex by June 1 of last year; PHPs once under contract with DHHS, and LME/MCOs by June 1, 2020. If successful, this legislation will extend the deadline to June 1, 2021 for a number of specific providers detailed by statute. https://www.ncleg.gov/Sessions/2019/Bills/House/PDF/H70v1.pdf
These materials have been prepared for informational purposes only and are not legal advice. This information is not intended to create, and receipt of it does not constitute, an attorney-client relationship. Internet subscribers and online readers should not act upon this information without seeking professional counsel.