With the North Carolina General Assembly scheduled to return to Raleigh on Tuesday, the North Carolina Health Care Association has suggested that conflicts over reforming required certificates may be resolved. It helped block the expansion deal.
For years, the hospital group has advocated expanding the Medicaid eligibility program to an additional 700,000 people, but it also opposes expanding access to healthcare related to reforms in CON regulations regarding providers. , in a rare instance of Gov. Roy Cooper and Republican lawmakers on the same side, increased pressure on the NCHA, whose opposition to CON reform has been a major obstacle in reaching the Medicaid Accord.
The CON Act allows state Departments of Health and Human Services to prohibit health care providers from “acquiring, replacing, or adding to facilities or equipment.” Critics have called it a government “permit slip” that stifles market competition. The NCHA opposed lawmakers enacting Medicaid expansion if the Senate version of the bill included her CON reforms.
“Unless there is a material change to North Carolina’s CON law, I don’t think the Senate will pass the expansion of Medicaid,” Senate Speaker Phil Berger, R-Rockingham, told reporters, noting that amendments to CON are not going to Medicaid. The lack of timely and available appointments can help address patient and hospital merger issues. He believes a deal could be reached soon if relaxing the CON law allows the market to provide facilities.
“It creates more competition for facility availability,” he said. “For a long time I [Federal Trade Commission] You should consider how things work in North Carolina, especially when it comes to providing healthcare in hospitals. “
The NCHA is now extending the proposal to lawmakers, who say they can agree to amend the CON Act at ambulatory surgery centers, and the group estimates it will cost the hospital $700 million in annual revenue. The proposal also indicates support for lawmakers to repeal his CON Act on psychiatric inpatient beds and chemical dependent beds.
Credit: Rose Hoban, northcarolinahealthnews.rog
“In order to move stalled negotiations forward, and in response to Senator Berger and Governor Cooper’s call to combine Medicaid expansion with certificate of need reform, our board has decided to introduce the certificate of need legislation. We have made the difficult decision to propose an amendment.” In her release to the press on Friday, NCHA chairman Dr. Roxie Wells, president of Cape Fear Valley Health Hoke Hospital. “Changes to the CON law could threaten the viability of community hospitals if not implemented carefully. We have a lot of trust in our legislative leaders to get this right. If it impairs access to local health services, I hope government leaders find resources to maintain critical health services and facilities, including the safety net services that people in North Carolina depend on. .”
As a condition of cooperation, the NCHA is proposing that the General Assembly pass an expanded bill to include participation in the Healthcare Access and Stabilization Program (HASP). This is a federal program that allows hospitals to lower federal taxpayer dollars in Medicaid reimbursements at a rate close to what private health insurance companies are paying. The program also covers increased reimbursement rates for rural hospitals, covering approximately 90% of unreimbursed costs. The association’s proposal suspends any reforms to the CON law until the state implements Medicaid expansion and the hospital begins obtaining her HASP funding.
The NCHA reports that hospitals now receive 72 cents for every dollar spent providing care to Medicaid and uninsured patients, representing a reimbursement gap of $2.3 billion annually.
The NCHA is a powerful lobbyist for state governments, but Cooper and Republican lawmakers are on the same page on the issue, putting pressure on hospital groups over the past few months to help them reach an agreement. rice field. Berger and North Carolina House Speaker Tim Moore’s office said they were considering the proposal, but did not comment on its feasibility.
With the legislative gavel in the ballot this week, no votes are scheduled, but Cooper and his Health and Human Services Secretary Cody Kinsley have told lawmakers that they will vote in September without waiting until the December legislative session. publicly asked to pass the bill.
