What Does the Law Mandate?

Through a law passed in 2015, the North Carolina Health Information Exchange Authority (NC HIEA) was created to oversee and administer the NC Health Information Exchange Network (NCGS 90-414.7). The NC HIEA is housed within the NC Department of Information Technology’s (DIT) Government Data Analytics Center (GDAC). The NC HIEA operates North Carolina’s statewide health information exchange—NC HealthConnex. NC HealthConnex is a tool that links disparate systems and existing HIE networks together to deliver a holistic view of the patient record through a secure, standardized electronic system so that providers can share important patient health information. The use of this system promotes the access, exchange and analysis of health information.

The law also requires:

  • By February 1, 2018, all Medicaid providers must be connected and submitting data to the HIE in order to continue to receive payments for Medicaid services provided.
  • By June 1, 2018, all other entities that receive state funds for the provision of health services (i.e. State Health Plan), including local management entities/managed care organizations, also must be connected.

What Does Connected Mean?

To meet the state’s mandate, a Medicaid provider is “connected” when its clinical and demographic information pertaining to services paid for by Medicaid and other State-funded health care funds are being sent to NC HealthConnex, at least twice daily—either through a direct connection or via a hub (i.e., a larger system with which it participates, another regional HIE with which it participates or an EHR vendor). Participation agreements signed with the designated entity would need to list all affiliate connections.