Priority Issues

The North Carolina Healthcare Association represents the collective voice of more than 130 hospitals and health systems across our state. In today’s rapidly evolving healthcare environment, hospitals are responding to numerous challenges that impact our ability to meet our mission to provide quality healthcare to everyone in the communities we serve. We are ready to partner with lawmakers to ensure North Carolina’s hospitals and health systems have the financial stability and resources needed to continue responding to the coronavirus (COVID-19), prepare for the next emergency, and serve the everyday healthcare needs of their communities.

NCGA Legislative Calendar

Federal Priorities

2023 Federal Legislative Priorities

The North Carolina Healthcare Association coordinates with the American Hospital Association to advocate for support from members of Congress on federal issues affecting hospitals and health care.

The following is a list of federal legislative priorities, and the associated position statements, that were approved by the Board of Directors for use during the 2022 Legislative Session:

Affordable Care Act

North Carolinians have come to rely on the protections of the Affordable Care Act (ACA). Any change made should ensure that those protections remain so that our hospitals can continue to provide high quality care to all.

Balance / Surprise Billing

Our patients deserve to have peace of mind about their healthcare finances. We support efforts to protect patients from surprise bills and leveling the playing field between providers and insurance companies by encouraging private negotiations without government controls.

EMTALA Reform

North Carolina hospitals and health systems urge Congress to modernize the Emergency Treatment and Active Labor Act to provide avenues for providers to get patients to the right care at the right place, implementing many of the changes provided during COVID-19.

Graduate Medical Education

Every North Carolinian deserves access to highly trained doctors. Congress should expand funding for medical education programs.

Home Hospital

Home Hospital is a promising model for health care organizations to deliver hospital-level treatment in a patient’s home. It is a safe and effective alternative for acute hospital care. A CMS waiver that enabled hospitals to be paid for Home Hospital during the pandemic boosted uptake of the program nationwide. NCHA favors extending the present Medicare waiver and enacting legislation that would provide a permanent and favorable regulatory environment.

To learn more about CaroNova’s work with Home Hospital, click here.

Insurance for All

North Carolina hospitals and health systems support broad insurance options and oppose efforts to move to one single payer.

Medicaid DSH Reductions

North Carolina hospitals and health systems support the disproportionate share hospital (DSH) programs and oppose any attempts to reduce funding for our most vulnerable. Further, cuts to the DSH program should be restored, especially for those states that continue to have a large uninsured population. Calculations should be based on the 2019 base year until the patient mix returns to post pandemic levels.

Learn more about Medicaid transformation in North Carolina.

Medicare Extenders

North Carolina hospitals and health systems support Medicare Extenders — such as the payments for Medicare-dependent hospitals (MDH) and those hospitals with lower volumes (LVH) — and urge Congress to permanently extend these programs so those most vulnerable hospitals can meet their community needs. Until patient volumes return to pre-pandemic levels, the base year should be 2019, rather than 2020.

Pandemic Preparedness Funding

Congress should increase COVID-19 relief funding to assist states and local health departments with ongoing surveillance, testing, surge planning, and patient care during the current and future public health emergencies. All hospitals should be equally eligible for relief funds.

Price Transparency

North Carolina’s hospitals, health systems and providers strive to provide our patients and their families with accurate cost and quality information. Regulations that require that providers disclose the negotiated rates of private insurers and others do not provide needed information on out-of-pocket costs, quality, or outcomes.

Site Neutral

North Carolina hospitals and health systems support variable reimbursement models that recognize the unique financial and charitable roll that hospitals play in the community and the fact that many patients who require hospital care have more complex health conditions.

Telehealth Expansion

The role of telehealth cannot be overstated in bringing care to communities who would otherwise be cut off from care; telehealth is a critical component of healthcare during the COVID-19 response and will be an essential component of care in the future. NCHA supports further protecting patients’ rights for telehealth coverage and expansion of broadband access to bring healthcare to every community.

340B Drug Pricing Program Support

Small, rural hospitals’ thin margins – made even tighter by COVID-19 – make programs like the 340B drug pricing program even more important to provide needed medical care to our most vulnerable communities. NCHA is committed to building a stronger, more transparent 340B program that benefits patients who wouldn’t otherwise have access to high-quality healthcare.

Learn more about the 340B Drug Pricing Program.

White and Brown Bagging

Congress should prohibit the use of both exclusive white and brown-bagging policies that compromise the timing and/or quality of care of drug therapies delivered to patients.

State Priorities

2023 State Legislative Priorities

North Carolina hospitals and health systems are in the midst of transforming our delivery of care to respond to the changing needs of our state. Our goal is to provide the appropriate level of care in the appropriate setting with the best outcomes. North Carolina’s hospitals are open all day, every day. We support more than 395,000 jobs statewide and contribute billions to the economy every year.

The following is a list of state legislative priorities, and the associated position statements, that were approved by the Board of Directors for use during the 2022 Legislative Session:

Balance / Surprise Billing

Behavioral Health Reform

Everyone deserves access to high-quality healthcare, which includes behavioral healthcare. NCHA supports policies to improve access regardless of insurance status and dismantling the root causes of inequality for behavioral health patients.

Certificate of Need Law

NCHA supports the current Certificate of Need law and urges our legislators to protect the law, thereby protecting access to care for all. The Certificate of Need law ensures that hospitals and health systems maintain the resources to provide high-value care to all in our communities and to plan for global pandemics and natural disasters.

Research papers on Certificate of Need:
Image vs. Reality: Mercatus, CON and Statistics in Search of Meaning, May 2016

First Do No Harm: Analyzing the Certificate of Need debate in North Carolina, July 2015

“Why Repealing CON is devastating for North Carolina’s rural hospitals” (2021)
Video 1 (CarolinaEast), Video 2 (Southeastern)

Graduate Medical Education

Every North Carolinian deserves access to highly trained doctors. North Carolina should continue funding medical education programs and explore ways to draw down more of our Federal tax dollars to add more slots to train medical students.

Healthcare Access and Stabilization Program

North Carolina’s hospitals and health systems support a Healthcare Access and Stabilization Program in North Carolina that provides federal resources to increase Medicaid rates closer to the cost of providing care at no cost to the state. This program has been approved in 10 states with strong support from healthcare and business communities.

Health Equity

North Carolina’s hospitals and health systems support work to provide care for all North Carolinians regardless of race, ethnicity, gender, insurance status, or income.

2023 NCHA Legislative Brief – Health Equity

Home Hospital

Home Hospital is a promising model for health care organizations to deliver hospital-level treatment in a patient’s home. It is a safe and effective alternative to acute hospital care. As hospitals treat more acute patients in their homes, potential patients with limited internet access are increasingly missing out. Furthermore, organizations developing programs will ultimately rely on consistent reimbursement. NCHA supports efforts to make Home Hospital more accessible and to guarantee all providers offering the program can be sufficiently reimbursed.

To learn more about CaroNova’s work with Home Hospital, click here.

Honoring Assignment of Benefits

During the COVID-19 pandemic, insurance companies continued to collect profits and negotiate against providers. North Carolina should join the majority of states that require insurance companies to honor the wishes of our patients who choose to assign their benefits to their provider.

Medicaid Expansion

NCHA supports Medicaid expansion to improve access to high-quality healthcare and close the gap for North Carolinians who are uninsured.

Expanding Medicaid in North Carolina (data story)

Faces of the Uncovered (video)

What is HASP — and why does it matter for North Carolina? (article)

How expanding Medicaid will improve healthcare equity for all North Carolinians (article)

What can Medicaid expansion do for rural North Carolina? (article)

For the uninsured, Medicaid expansion in North Carolina could be life-changing (article)

Medicaid Managed Care

Medicaid is an important program, ensuring the state’s vulnerable populations, including children and pregnant women, receive needed care. We support a transformed program that ensures high quality outcomes, provider protections, and maximizes federal funds.

NCHA Medicaid Managed Care Toolkit

NCHA Medicaid Managed Care Call Center Resource Guide

NCHA Medicaid Managed Care Provider Resource Guide

NCHA Medicaid Managed Care Patient Resource Guide

(Spanish Version) NCHA Plan de Salud del Programa Medicaid de Carolina del Norte

Tax Treatment Preservation

North Carolina’s not for profit hospitals and health systems support the current non-profit sales and property tax laws and also support efforts to exempt non-profits from paying sales taxes.

Telehealth Expansion

Read about how NC hospitals are changing lives with telehealth services.

Transparency

North Carolina hospitals and health systems strive to provide our patients and their families with accurate cost and quality information. Regulations that require that providers disclose the negotiated rates of private insurers and others do not provide needed information on out-of-pocket costs, quality, or outcomes.

White and Brown Bagging

The General Assembly should prohibit the use of both exclusive white and brown-bagging policies that compromise the timing and/or quality of care of drug therapies delivered to patients.

Workforce

Creating and sustaining the healthcare workforce is essential to providing compassionate and quality care across our state. COVID-19 has exacerbated long-standing workforce challenges and adding pressure to an already exhausted workforce. NCHA supports comprehensive solutions addressing the entire pipeline, from preparing tomorrow’s healthcare leaders through world-class education programs to bolstering the resiliency of today’s healthcare heroes with the resources they need to continue providing high-quality care.

Legislative Summaries

The North Carolina Healthcare Association provides legislative summaries for our member hospitals and health systems to keep them informed about the work we do on their behalf at the North Carolina General Assembly and in Congress.

To learn more about these priorities, please log in to NCHA Member Resources.

NCHA Contact

John Thompson

Vice President
Government Relations (State)
919-677-4119
jthompson@ncha.org

Who Represents Me?

US CONGRESS

NC GENERAL ASSEMBLY

Committee Meeting Notices

NCHA will monitor and report on all committee action. For those interested in receiving NC General Assembly Committee notices, the information is here:

To subscribe to receive every committee notice for all 2021 House standing committees, visit All House Standing Committee Meetings.

To subscribe to receive every committee notice for all 2021 Senate standing committees, visit All Senate Standing Committee Meetings.

If you want to receive committee notices from one or multiple committees, you will need to subscribe individually to each 2021 standing committee.

All committee information, including links to sign up for “committee notices by email,” can be found at the Main NCLeg Committee Meetings page.