The North Carolina Medical Society (NCMS) spearheaded the legislative effort and worked diligently to ensure the provision was finalized this year. You can review the two-sentence provision on page 20 of HB 287.
State insurance laws have not kept pace with recent innovations in health care delivery and financing, and therefore do not squarely address the latest emergence of risk-sharing providers. This led to uncertainty in how the NC Department of Insurance would view Medicare ACOs from a regulatory perspective. CMS’s Next Gen ACO application raised the stakes even higher by requiring applicant ACOs to demonstrate compliance with state insurance requirements for risk-sharing providers.
This statutory change not only resolves the uncertainty, but also removes a regulatory barrier to our local pursuits of the triple aim and value-based health care. Several members of our ACO Collaborative and MSSP Council helped NCMS tackle this problem, so we thank them for their engagement and assistance in crafting a solution.