The North Carolina Supreme Court has ruled the lawsuit filed by eight physician groups against the NC Department of Health and Human Services (NC DHHS) and CSRA for the disastrous implementation of the NCTracks Medicaid billing system cannot yet proceed to trial. The case of Abrons v. NC DHHS claimed that because the system was improperly designed and rushed into production, Medicaid providers were not correctly reimbursed for treating patients and incurred damages as a result.

The case has been tied up on preliminary questions centering on whether superior court was the proper venue for initiating the lawsuit. In 2016, the North Carolina Court of Appeals agreed with the physicians, ruling that the case could proceed in superior court as originally filed.  But NC DHHS and CSRA appealed that ruling to the state’s highest court. The NCMS, in a coalition with the NC Academy of Family Physicians, NC Healthcare Association, NC Healthcare Facilities Association, and the American Medical Association, participated as amicus curiae in support of the physician-plaintiffs.

But in its decision last week, the supreme court came to a different result, ruling that the physicians should have first sought relief directly from NC DHHS or the NC Office of Administrative Hearings (OAH), instead of proceeding straight to superior court. Justice Barbara Jackson, writing for the Court, stated that the physicians had not exhausted the appropriate administrative appeals and disagreed with their arguments that the appeals process was futile based on the extreme facts of this case. Justice Jackson did note, however, that by initiating the lawsuit when they did, the physicians could still return to the agency or OAH to press their claims and seek relief.  Read the ruling.