HIEA Update: Medicaid and State Health Plan Providers

NASW-NC gave members regular updates on our advocacy efforts around the enactment of the Statewide Health Information Exchange Act since 2018. We let members know in July 2022, the North Carolina General Assembly enacted the Act that impact health care providers and organizations that serve state-funded patients (e.g., Medicaid recipients and State Health Plan members). Specifically, the 2022 state budget and the Statewide Health Information Exchange Act includes the following:

• Certain organizations who receive state funds for treating Medicaid recipients and State Health Plan patients remain subject to a January 1, 2023, deadline to connect to NC HealthConnex and submit required data to the state.
• The enforcement mechanism in the Statewide Health Information Exchange Act that makes connection to the HIE and submission of required data to the state prerequisites for a health care provider to receive state funds is temporarily suspended “until a bill designating a lead agency responsible for enforcement of the Statewide Health Information Exchange Act is enacted into law.” This bill has not yet been introduced and we will keep members informed of our advocacy efforts.
• In March 2023, the General Assembly received a report outlining the status of organizations that met – or failed to meet – the January 1, 2023, connection and submission deadline.

Do I Still Need To Connect?

It is imperative that providers, health care organizations, pharmacies and others subject to the Statewide Health Information Exchange Act take immediate steps to connect to NC HealthConnex. The connection deadline of January 1, 2023, was not delayed or extended, and enforcement of the condition of receiving state funds is only suspended temporarily.

What If I’m in the Process of Connecting?
Health care organizations and providers that have begun the technical process of connecting to NC HealthConnex are considered to be making good-faith efforts to fulfill the connection mandate. They should continue onboarding or risk losing their order in the queue. Organizations that have signed a participation agreement with NC HIEA but are not yet live and submitting data, are considered to be making good-faith efforts to connect as well. As providers are invited to begin the technical connection process, they should be ready to proceed or risk being moved to the back of the onboarding queue.

Not Connected? Read on for Opportunities To Improve Patient Care During the Onboarding Process

• If you have an executed Full Participation Agreement and are awaiting your data connection to NC HealthConnex, there are several services and training materials to which you already have access.
• You may request credentials to access the NC HealthConnex web-based, secure Clinical Portal, which allows you to view data that is currently uploaded to NC HealthConnex from other providers on patients with whom you have a treatment relationship. While your own data is not uploaded until you “go live,” meaning you have completed your connection project, you will still have access to the data of other providers who may have treated your patient.
• Additionally, you can enroll in the event notification service, NC*Notify, which provides ADT (admission, discharge, transfer) notifications on patients you select to monitor. This can be useful for knowing important care information such as a high-risk patient who has visited the ER or when a patient has transitioned to or from a residential care facility.
• The NC HIEA also offers several other value-added services, including Direct Secure Messaging, an encrypted email tool that allows clinicians to send protected health information about their patients through a secure encrypted network, and Public Health Reporting, including the N.C. Immunization Registry, Diabetes Registry, and Electronic Lab Reporting
• Once your connection project has been added to the project intake list, you and your technical point of contact will be contacted to complete a project scoping checklist and confirm any additional items needing to be completed prior to project kickoff.
• In the meantime, you can engage meaningfully in the onboarding process by taking advantage of online training materials such as webinars, user guides, and self-paced modules on our website. You can also request training for your practice using this form.

More information:

• For information on who is currently connected to NC HealthConnex, visit the NC HealthConnex Participant Map.
• For providers who would like to inquire about their organization’s connection status, please email HIESupport@sas.com.
• For questions regarding the State Health Plan network, please contact BCBSNC Provider Services at 1-800-777-1643 or providerupdates@BCBSNC.com.
• For questions regarding Medicaid, please contact Medicaid.ProviderOmbudsman@dhhs.nc.gov.
• All other questions may be directed to the hiea@nc.gov.