The NCMS has been working under the following priorities during the budget process.
1. Support Medicaid Reform – Work with the NC General Assembly, the Office of the Governor and the Department of Health and Human Services (DHHS) to develop and implement reform that would focus on patient-centered care while achieving predictability and cost-savings in the Medicaid system without going to a traditional, commercial managed care program in NC.
2. Encourage Shared Savings – As part of the first goal, we encourage utilization of shared savings models, similar to those being done in Medicare, as a part of the Medicaid reform discussion. This is a way to avoid further cuts to physician reimbursement, and protect access to care for the growing Medicaid population.
3. Require Health Information Exchange (HIE) Utilization – One requirement for true patient-centered care management is data sharing. The NCMS has long advocated for statewide utilization of the HIE to overcome this communication gap, which limits our physicians’ ability to reduce utilization and provide the most appropriate care at the right time for each patient.
4. Oppose Triage Fees in the Emergency Department – The NCMS opposes the Senate proposal to pay emergency providers less if the condition treated was not an emergency. The goal of any such provision would be to reduce unnecessary emergency department utilization. The proposed approach would penalize the provider rather than change the behavior of the Medicaid patient.
5. Oppose further Administrative Burdens – The Senate proposed numerous additional administrative costs to be borne by providers, including continuing the $100 Medicaid enrollment fee, prior authorization for more than 10 office visits a year and collecting additional co-pays from Medicaid patients.
6. Oppose the Certificate of Need (CON) policy change in the Senate Budget – This policy change would eliminate the need for any Department review of replacement equipment purchases by existing CON holders. This is a significant policy change that should be debated openly and independently of the massive budget bill.
The meetings tomorrow will be broadcast on the Internet. You can listen in by clicking on the following link, http://www.ncleg.net/Audio/Audio.html, and then clicking Appropriations Committee Room (Room 643). Watch for messages from NCMS on action you can take.