Attention: Hospitals, Physicians, Physician Assistants, Pharmacies and Nurse Practitioners Are you in Compliance with NC Law?

One of the goals of a transformed health care system is for real-time clinical and demographic data to be made available to all health care providers involved in a patient’s care so that they can securely share health information concerning that patient with each other. North Carolina’s state-designated health information exchange, NC HealthConnex, was created in 2015 by the North Carolina General Assembly to help bridge the gap between disparate systems and health care networks to support whole patient care. With over 5 million unique patient records and growing, NC HealthConnex is working to connect the state’s health care providers to deliver a holistic view of a patient’s record. The North Carolina Health Information Exchange Authority (NC HIEA) is the agency managing the statewide NC HealthConnex.

New Legislative Update

During the legislative session this summer, legislators approved new laws that will impact NC HealthConnex and the health care community.   NCSL 2018-41 extends the mandatory date for connection to NC HealthConnex to 2021 for ambulatory surgical centers and dentists and clarifies that pharmacies shall submit claims - rather than clinical - data to NC HealthConnex.

NC HealthConnex Extension Process

The NC HIEA and DHHS understand that many health care providers were not be able to connect to NC HealthConnex by the mandated deadlines. The General Assembly (NCGS § 90-414.4 (a2)) has permitted the NC HIEA and DHHS to grant limited extensions to health care providers to connect to NC HealthConnex and begin submitting data as required by law. Any organization that is not live and is affected by the June 1, 2018, deadline will automatically receive an extension once they have an executed Participation Agreement on file.

If you recently submitted your Participation Agreement and fall under the June 1, 2018, deadline, you will receive notice of your approved extension when your executed Participation Agreement is returned to you. There is no need to submit an extension form.

NC DHHS Corrective Action Plan

NC Medicaid will work collaboratively with health care providers who have not initiated connection to NC HealthConnex by the June 1, 2018 deadline.  Providers who have not started the connection process will be placed on corrective action plans to assist with compliance. In the coming months, NC Medicaid will contact provider organizations to discuss corrective action. At this time, all providers will continue to be enrolled as NC Medicaid providers and, as they file claims, will receive reimbursements for services and treatment of NC Medicaid beneficiaries.

Medicaid appreciates the many providers across the state who have initiated a connection and are making data available through the system. We will continue to work closely with the HIEA to ensure that NC HealthConnex develops to support your priorities and enable all of us to better serve patients and families.

Providers with questions can contact the NC HIEA staff at 919-754-6912 or hiea@nc.gov  or Medicaid at Renee.McCoy@dhhs.nc.gov  for Medicaid reimbursement related questions.