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North Carolina Health News

13 stories

Managed Care·NC·2d ago

NC's Four Medicaid MCOs Launch Joint Fraud Task Force

North Carolina's four Medicaid managed care organizations, AmeriHealth Caritas, Healthy Blue, UnitedHealthcare and Carolina Complete Health, formed a joint task force in August through the North Carolina Association of Health Plans to combat fraud, waste and abuse. The task force unites each plan's special investigative units and government relations staff so investigators can share billing data and coordinate on providers that contract across multiple MCOs. The effort emerged from a meeting with State Auditor Dave Boliek amid heightened federal and state scrutiny of Medicaid spending, including recent fraud cases involving a substance abuse treatment center and a nursing home. Organizers say applied behavioral analysis therapy billing is a top area of concern given rapidly rising spending.

State Policy·NC·9d ago

North Carolina Restores Perinatal Quality Collaborative After Medicaid Funding Dispute

North Carolina has restored funding for the Perinatal Quality Collaborative of North Carolina, enabling dozens of hospitals statewide to participate in maternal and newborn care research beginning next year. The collaborative lost funding in October 2025 due to a Medicaid funding dispute, delaying planned research projects that were originally scheduled to launch in 2025. The restoration allows the state's hospitals to resume quality improvement work targeting maternal and perinatal outcomes. This matters for North Carolina providers and state Medicaid officials managing maternal health initiatives under heightened federal scrutiny of maternal outcomes.

State Policy·NC·10d ago

UNC Health Pardee Opens Adolescent Behavioral Health Inpatient Unit in Hendersonville

UNC Health Pardee has opened an inpatient adolescent behavioral health center in Hendersonville, North Carolina, serving teens in Henderson and surrounding counties experiencing mental health crises. The new facility addresses a regional gap in youth psychiatric services. The opening is relevant to North Carolina Medicaid given that Medicaid covers approximately half of all children in the state and is a major payer for behavioral health services, including inpatient psychiatric care for eligible adolescents.

Federal Policy·NC·17d ago

Federal Medicaid Restrictions in H.R. 1 Set to Take Effect in North Carolina

Sweeping federal Medicaid restrictions included in H.R. 1 are about to take effect in North Carolina, affecting the program that covers one in four state residents. North Carolina Medicaid Director Melanie Bush characterized these provisions as likely the most significant changes in the program's history. The new federal restrictions will fundamentally reshape how Medicaid operates in the state, though specific implementation details and effective dates require further clarification from the full article text.

State Policy·NC·26d ago

North Carolina Resumes Healthy Opportunities Pilot with $25M, Down from $80M Request

North Carolina is restarting its Healthy Opportunities Pilot after a one-year suspension, but with $25 million in funding — less than one-third of the $80 million the state requested. Food-related services will likely resume first, while transportation services like car repairs will not return in their previous form under the new Medicaid waiver structure. The state is still finalizing implementation details. The reduced funding marks a significant scaling back of the pilot, which provided social determinants of health services to Medicaid enrollees in selected regions.

State Policy·NC·27d ago

UNC Health Pardee Expands Behavioral Health and Trauma Services in Western North Carolina

UNC Health Pardee opened a 23-bed adolescent mental health unit in August and received Level III Trauma Center designation, expanding specialty services in western North Carolina. The Henderson County hospital has increased its Buncombe County patient volume by 60% since 2019, from 12,973 to 20,981 residents, while adding cancer infusion services and new medical offices in Brevard and Mills River. Pardee operates under a 2011 management agreement with UNC Health that maintains 100% local ownership while providing access to the academic health system's resources. The expansion comes as Mission Health's market position weakens following its 2019 acquisition by HCA, creating opportunities for Pardee to grow in traditionally Mission-dominated service areas.

State Policy·NC·30d ago

North Carolina Budget Adds $160M for Childcare Subsidies, Pilots Family Childcare Home Supports

North Carolina's new state budget includes approximately $160 million in additional childcare subsidy funding, bringing annual subsidy spending above $650 million and establishing the state's first reimbursement floor tied to 2023 market rates. The budget also funds rural home-based childcare pilots, workforce academies, and a liability insurance study, as the state grapples with a dramatic decline in licensed family childcare homes — from 4,500 in 2005 to just over 1,000 today. Ninety-six percent of providers will see subsidy reimbursement increases. The North Carolina Task Force on Child Care and Early Education, which met on August 31, emphasized that family childcare homes provide essential capacity for infants, toddlers, nontraditional work schedules, and rural communities, but providers face financial barriers including health insurance costs, administrative burdens, and lack of retirement benefits that undermine program sustainability.

Federal Policy·32d ago

Federal Rural Health Transformation Program Draws Criticism Over Lack of Transparency

The $50 billion federal Rural Health Transformation Program, created in summer 2025 as part of President Trump's One Big Beautiful Bill Act, faces criticism from policy groups for insufficient transparency one year into implementation. CMS will publish only an annual aggregate report, not proactively release individual state reports or funding recipient details, leaving transparency largely to states with widely varying disclosure practices. Multiple states have declined public records requests, held closed meetings, or sought to shield applications from public view. The five-year program was designed to offset anticipated Medicaid spending reductions of over $900 billion that disproportionately affect rural communities.

State Policy·NC·32d ago

North Carolina Expands School-Based Mental Health Through Federal Project AWARE Grant

North Carolina received two rounds of federal SAMHSA Project AWARE grants totaling $8.8 million (2018) and additional funding (2021) to embed mental health services in six school districts: Beaufort, Cleveland, Rockingham, Jackson, Nash, and Sampson counties. The program created a licensed clinical mental health counselor job classification for school districts, established training programs, and built infrastructure for mental health service delivery in schools. SAMHSA announced $55.7 million in new funding in July 2026, with North Carolina applying for a third cohort; the state expects to learn whether it received funding by September 1, 2026. The initiative replaced fragmented approaches to student mental health with coordinated school-based services.

Federal Policy·34d ago

Trump Bill Allocates $213M for Rural Health, Cuts $900B from Medicaid Over Decade

President Trump's One Big Beautiful Bill Act (H.R. 1) includes $213 million for rural health programs while cutting over $900 billion from Medicaid over 10 years, per CBO analysis. North Carolina plans to use its share of rural health funding to expand maternal health initiatives including postpartum identification wristbands. Georgetown researchers warn the law's Medicaid cuts and new work requirements threaten state postpartum coverage extensions from 60 days to one year that nearly all states adopted since 2022. States may now eliminate those extensions or inadvertently drop postpartum enrollees who should be exempt from work requirements.

State Policy·NC·60d ago

Study Finds Medicaid Expansion Did Not Reduce Firearm Suicides Among Most Men

A new study found that Medicaid expansion has not reduced firearm suicide rates among most men, despite documented improvements in health care access and behavioral health treatment availability for expansion populations. The research challenges assumptions about the relationship between Medicaid coverage and suicide prevention outcomes for male enrollees. The findings have implications for state Medicaid agencies and managed care organizations designing behavioral health interventions and measuring quality outcomes in expansion populations, particularly as states continue to evaluate the effectiveness of coverage expansions on mental health and mortality metrics.

Legal·NC·68d ago

North Carolina Monitor Flags HCA for Potential Breach of Mission Hospital Sale Agreement

Dogwood Health Trust, the independent monitor overseeing HCA Healthcare's 2019 acquisition of Mission Hospital in North Carolina, notified the state attorney general that HCA may be in noncompliance with the sale contract. The two potential violations involve a federal warning in October 2025 that Mission risked losing Medicaid and Medicare participation status, and a second undisclosed issue. The monitor's role is to enforce conditions negotiated when HCA purchased the hospital, which serves as a critical safety-net provider in western North Carolina. The attorney general's office will determine whether enforcement action is warranted.

State Policy·NC·69d ago

North Carolina AG Says Federal Medicaid Work Requirement Rule Shifts Millions to Counties

North Carolina's attorney general says a last-minute federal rule change regarding Medicaid work requirements will impose significant costs on counties. Congress included a medically frail exemption in last year's federal Medicaid work requirement law for individuals with serious or complex conditions like cancer, Parkinson's disease, and cystic fibrosis. The state AG contends recent federal regulatory changes will shift financial responsibility for administering or monitoring these exemptions to county governments, resulting in millions of dollars in unexpected local costs. The timing and specific implementation details of the rule change are causing concern about counties' ability to absorb these new expenses.

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