NC Medicaid Electronic Health Record Incentive Program

Providers are no longer permitted to submit attestations for the NC Medicaid EHR Incentive Program. 

The NC Medicaid EHR Incentive Program was created by the federal government as part of the American Recovery and Reinvestment Act of 2009. The goal of the program was to encourage eligible professionals (EP), eligible hospitals (EHs), and critical access hospitals (CAHs) to adopt, implement, or upgrade (AIU) to a certified EHR technology, and then to demonstrate meaningful use (MU) of that technology.

In the July 28, 2010 final rule titled “Medicare and Medicaid Programs; Electronic Health Record Incentive Program” at 75 FR 44319, CMS established that, in accordance with section 1903(t)(4)(A)(iii) of the Act, in no case may any Medicaid eligible professional (EP) receive an incentive after 2021 (see § 495.310(a)(2)(v)). Therefore, December 31, 2021 is the last date that states could make incentive payments to Medicaid EPs. To ensure states can issue all payments by December 31, 2021, in 83 FR 59452, CMS established a deadline of October 31, 2021 for receiving EP attestations.

The NC Medicaid EHR Incentive Program staff would like to thank all the Medicaid providers that participated throughout the years. It was our pleasure to work with the NC Medicaid provider community and to assist in incentivizing providers to adopt and meaningfully use EHRs within their practice.

The NC Medicaid EHR Incentive Program extended 11 years, 2011 through 2021.

Program Year 2021 closed on Oct 31, 2021. We are no longer accepting attestations for the NC Medicaid EHR Incentive Program. 

All providers who receive an EHR incentive payment are subject to audit for six years post-payment.

In the July 28, 2010 final rule titled “Medicare and Medicaid Programs; Electronic Health Record Incentive Program” at 75 FR 44319, CMS established that, in accordance with section 1903(t)(4)(A)(iii) of the Act, in no case may any Medicaid eligible professional (EP) receive an incentive after 2021 (see § 495.310(a)(2)(v)). Therefore, December 31, 2021 is the last date that states could make incentive payments to Medicaid EPs. To ensure states can issue all payments by December 31, 2021, in 83 FR 59452, CMS established a deadline of October 31, 2021 for receiving EP attestations.

See a list of providers and hospitals who were paid Jan 1, 2015 through Nov. 23, 2021.

See a cumulative list of all providers paid from 2011 through Jan 2015.

Note: Per CMS' Stage 1 Final Rule and 495.10(f), NC Medicaid EHR Incentive Payments are linked to professionals and could have been assigned on a voluntary basis to an affiliated organization promoting the adoption and meaningful use of certified EHR technology. It was against federal and program rules for an organization to require that affiliated EPs assign an incentive payment to a practice or organization.

Need help locating a payment?

If the provider is listed on the Paid To Date spreadsheet on the Path To Payment tab, s/he was approved for an NC Medicaid EHR Incentive Program payment and the Program team authorized issuance of payment to the payee NPI listed on their attestation. If a provider is unable to locate that payment, please contact CSRA (formerly CSC), the fiscal agent for NC DHHS, which operates the NCTracks system. They can be reached at 800-688-6696 or NCTracksprovider@nctracks.com. Request that the representative open a PEGA ticket to forward your concern to their Finance department. The Finance team can track electronic payments and provide information on when electronic funds transfer occurred and to what bank account the funds were sent. They can also provide the relevant page of the remittance advice (RA) with details on payment.

For assistance reading an RA, NCTracks has several trainings that can be used a point of reference. NCTracks has also recorded a Computer-Based Training, accessible through their provider training. Learn more about NCTracks.

Providers who want a copy of an RA generated after July 1, 2013, should be able to retrieve it from the Message Center Inbox on the secure NCTracks Provider Portal. The RAs are retained in the Message Center Inbox for up to seven years. There is no cost associated with retrieving an NCTracks RA from a previous checkwrite using the Message Center Inbox. See the User Guide “How to Retrieve an NCTracks RA from a Previous Checkwrite” on the Provider User Guides and Training page of the public Provider Portal.

The NC Medicaid EHR Incentive Program is no longer accepting attestations. 

In the July 28, 2010 final rule titled “Medicare and Medicaid Programs; Electronic Health Record Incentive Program” at 75 FR 44319, CMS established that, in accordance with section 1903(t)(4)(A)(iii) of the Act, in no case may any Medicaid eligible professional (EP) receive an incentive after 2021 (see § 495.310(a)(2)(v)). Therefore, December 31, 2021 is the last date that states could make incentive payments to Medicaid EPs. To ensure states can issue all payments by December 31, 2021, in 83 FR 59452, CMS established a deadline of October 31, 2021 for receiving EP attestations.

Current HITECH Documents

North Carolina State Medicaid Health Information Technology Plan (SMHP) (PDF, 2,408 KB)

North Carolina Medicaid Health Information Technology Implementation Advance Planning (I-APD) -Update – FFYs 2020-2023 (PDF, 1,800 KB)

Security Risk Assessment Resources

In addition to the SRA webinar above, find below a list of several resources that are available to assist providers with conducting a security risk assessment:

Healthit.gov's Security Risk Assessment Tool

HHS' "The Security Rule" Website

HHS' Security Standards: Technical Safeguards

HHS' Security Standards: Administrative Safeguards

HHS' Security Standards: Physical Safeguards

CMS' Security Risk Analysis Tip Sheet: Protect Patient Health Information

The NC Medicaid EHR Incentive Program has a Frequently Asked Questions page with a library of FAQs available to help answer common provider questions. Providers are also encouraged to submit questions to NCMedicaid.HIT@dhhs.nc.gov. Responses will be used to update this FAQ section.

More FAQs are also available on CMS' Promoting Interoperability Program (formerly EHR Incentive Program) website.

Contact the NC Medicaid EHR Incentive Program at NCMedicaid.HIT@dhhs.nc.gov. We do not accept documentation via fax.

NC HealthConnex is a secure electronic network that facilitates conversations between health care providers, allowing them to access and share health-related information across North Carolina to improve coordination of care for patients. NC HealthConnex allows participating providers to access their patients’ comprehensive records across multiple providers, as well as review labs, diagnostics, history, allergies, medications, and more to help decrease redundancy and allow for more efficient and accurate diagnoses, recommendations and treatment.

Created by the North Carolina General Assembly (NCGS 90-414.7), NC HealthConnex is the state-operated health information exchange and is managed by the North Carolina Health Information Exchange Authority (NC HIEA) housed within the N.C. Department of Information Technology.

As of June 2021, there are more than 60,000 providers with contributed records, more than 6,000 health care facilities, including 125 hospitals, submitting data and more than 20 connected border & interstate health information exchanges.

NC HealthConnex Connection Deadlines Extended to January 2023
Governor Roy Cooper signed House Bill 395 (now NCSL 2021-26) into law on May 27, 2021, to allow additional time for providers to connect to the state-designated health information exchange NC HealthConnex, among other things.

The North Carolina Health Information Exchange Authority (NC HIEA) Advisory Board and the North Carolina Department of Information Technology led a collaborative effort to bring additional relief to health care providers who have been on the front lines of the COVID-19 pandemic. Extending the deadline until January 2023 will allow additional time for health care providers to complete their technical onboarding process without being out of compliance with the HIE Act. Please note that there are more than 5,000 facilities in onboarding at this time. Providers should continue to connect as we have no guarantees of additional extensions and, as noted below, the General Assembly is requiring compliance reports by March 1, 2022.

Among other changes to the HIE Act, the NC HIEA Advisory Board has been tasked with developing final recommendations regarding appropriate features or actions to support the Statewide Health Information Exchange Act and to report on the status of entities and providers not connected to the HIE Network as identified under subsection (b) of this section, to the Joint Legislative Oversight Committee on Health and Human Services on or before March 1, 2022. Additionally, the NC HIEA has been directed to work with the State Health Plan Division, Department of State Treasurer, and the Division of Health Benefits, Department of Health and Human Services, to identify providers and entities who have not connected to the HIE in accordance with G.S. 90-414.4 and to contact each entity or provider to ascertain their connection status and to inform them of the connection requirements. By November 1, 2021, the Department of State Treasurer, Department of Health and Human Services, and licensing boards, shall assist the NC HIEA with contact information and addresses for providers and entities. 

Additional Changes and Additions to the HIE Act Per NSCL 2021-26 (HB395 Bill Analysis):
Section 1 provides that the N.C. Department of Information Technology; Department of State Treasurer, State Health Plan Division; and N.C. Department of Health and Human Services, Division of Health Benefits; have an affirmative duty to facilitate and support participation by covered entities in the Statewide Health Information Exchange Network.

Section 2 allows the N.C. Department of Health and Human Services, if authorized by the NC HIEA, to submit data on behalf of Prepaid Health Plans and local management entities/managed care organizations (LME/MCOs). The section also extends connection deadlines as follows:

• Extends the connection deadline for most providers of Medicaid and State-funded health care services, and affiliated entities, until January 1, 2023 (currently October 1, 2021). 
• Extends the connection deadline for physicians who perform procedures at ambulatory surgical centers, dentists, psychiatrists, and the State Laboratory of Public Health until January 1, 2023 (currently June 1, 2021). 
• Extends the connection deadline for pharmacies and State health care facilities operated under the Secretary of the Department of Health and Human Services (State psychiatric hospitals, developmental centers, alcohol and drug treatment centers, neuro-medical treatment center, and residential programs) until January 1, 2023 (currently June 1, 2021). 

Sections 2 and 4 remove ambulatory surgical centers, as defined in G.S. 131E-146, from the requirements to submit demographic and clinical data but require a physician who performs a procedure at the ambulatory surgical center to be connected to the HIE Network and to submit the data.

Section 5 prohibits balance billing when an in-network provider or entity with the State Health Plan for Teachers and State Employees does not connect to the HIE Network. The section specifically provides that under the State Health Plan an in-network provider or entity who renders health care services, including prescription drugs and durable medical equipment, and who is not connected to the HIE Network, is prohibited from billing the State Health Plan or a Plan member more than either party would be billed if the provider was connected to the HIE Network. Note: Providers participating in the State Health Plan network should reach out to the State Health Plan with questions regarding this provision at BCBSNC Provider Services at 1-800-777-1643 or providerupdates@BCBSNC.com. 

Section 6 prohibits the NC HIEA from fulfilling requests for electronic health information from an individual, individual's personal representative, or an individual or entity purporting to act on an individual's behalf and requires the Authority to provide educational materials on accessing this information from other sources.

Section 7(a) requires the Health Information Exchange Advisory Board to submit recommendations regarding appropriate features or actions to support the Statewide Health Information Exchange Act and to report on the status of entities and providers not connected to the HIE Network as identified under subsection (b) of this section, to the Joint Legislative Oversight Committee on Health and Human Services on or before March 1, 2022. Section 7(b) requires the HIE Authority to work with the State Health Plan Division, Department of State Treasurer, and the Division of Health Benefits, Department of Health and Human Services, to identify providers and entities who have not connected to the HIE in accordance with G.S. 90-414.4 and to contact each entity or provider to ascertain their connection status and to inform them of the connection requirements. By November 1, 2021, the Department of State Treasurer, Department of Health and Human Services, and licensing boards shall assist the NC HIEA with contact information and addresses for providers and entities. 

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 hiea@nc.gov.

To request a temporary Hardship Extension, providers must submit the NC DHHS HIE Hardship Extension Request Form electronically to the DHB Provider Ombudsman at Medicaid.ProviderOmbudsman@dhhs.nc.gov. The form is available at https://medicaid.ncdhhs.gov/providers/forms under Category “HIE Hardship Extension.” Inquiries must be submitted by the enrolled provider, the office administrator (OA), or a managing employee of record. This process applies to Medicaid, NC Health Choice, NC State Health Plan and BCNC Blue Option participating providers.

Providers receiving the Hardship Extension are still required to comply with the HIEA participation agreement, the technical onboarding requirements documented in the NC HIEA contract, and must be connected and submitting data by the Hardship Extension deadline date of Dec. 31, 2022. Connecting to NC HealthConnex can take up to 12 months depending on the provider’s EHR status, so providers are strongly encouraged to begin technical development no later than Jan. 1, 2022. 

Diabetes Specialized Public Health Registry

Effective June 1, 2018, the NC Diabetes Specialized Public Health Registry will be available for population health purposes. Full participants of NC HealthConnex are eligible to participate in the registry by signing the NC HealthConnex Diabetes Registry form. Data submitted to NC HealthConnex will be included in the Diabetes Registry, as appropriate. No additional data submission from participants is required. The NC HealthConnex Diabetes Registry supports attestation for Meaningful Use Stage 3 for eligible hospitals, eligible critical access hospitals, and eligible professionals and Medicare Quality Payment Program Advancing Care Information for eligible clinicians.