Author: NC HIEA, 919-754-6912 or hiea@nc.gov
One of the goals of a transformed health care system is for near real-time clinical and demographic data to be made available to all health care providers involved in a patient’s care so that they can securely share health information concerning that patient with each other.
North Carolina’s state-designated health information exchange, NC HealthConnex, was created in 2015 by the North Carolina General Assembly to help bridge the gap between disparate systems and health care networks to support whole patient care. With six million unique patient records and growing, NC HealthConnex is working to connect the state’s health care providers to deliver a holistic view of a patient’s record. The North Carolina Health Information Exchange Authority (NC HIEA) is the agency managing the statewide NC HealthConnex.
What’s the law?
State law (N.C.G.S. § 90-414.4) requires that all health care providers who receive any state funds for the provision of health care services (e.g. Medicaid, NC Health Choice, State Health Plan, etc.) connect and submit patient demographic and clinical data to NC HealthConnex by certain dates in 2018 and 2019 in order to continue to receive payment for services.
- Hospitals as defined by G.S. 131E-176(3), physicians licensed to practice under Article 1 of Chapter 90 of the General Statutes, physician assistants as defined in 21 NCAC 32S .0201 and nurse practitioners as defined in 21 NCAC 36 .0801 who provide Medicaid services and who have an electronic health record system shall connect by June 1, 2018.
- All other providers of Medicaid and state-funded services shall connect by June 1, 2019. (see exceptions below from NCSL 2018-41)
- Dentists and ambulatory surgical centers are required to submit clinical and demographic data by June 1, 2021.
- Pharmacies are required to submit claims data pertaining to State services once per day by June 1, 2021, using pharmacy industry standardized formats.
- LME/MCOs are required to submit claims and encounter data by June 1, 2020.
Note: Recently introduced legislation (HB70) has a number of provisions that may impact the current state requirements and implementation deadlines. The bill would: delay the June 1, 2019, deadline to June 1, 2020; would exempt certain providers from the requirement to submit data; and would provide a hardship exemption for certain providers based on criteria set by DHHS in consultation with DIT among other provisions. This is still a bill and has not been signed into law as of April 11, 2019.
How to Connect?
The first step in connection is reviewing and signing the Participation Agreement. The Participation Agreement is the contract that governs the data sharing between your practice and the NC HIEA. For more information, visit the HIEA’s How to Connect Webpage.
The second step is to have the technology in place. The NC HIEA Participation Agreement requests EHRs that are minimally capable of sending HL7 messages, version 2 and higher.
Additionally, NC HIEA, in collaboration with the NC Department of Health and Human Services, has established an extension process. Once a health care organization signs the Participation Agreement with the HIEA and begins onboarding, an extension of time is automatically granted to allow time for the provider to become compliant under the HIE Act. Payments will not be withheld from providers who have been granted extensions of time.
The NC HIEA holds monthly “How to Connect” webinars on the last Monday of every month at 12 noon. Click here to register.