NC HIEA November 2023 Update

Comment Period on Proposed Information Blocking Rule, New Telehealth Privacy and Security Resources, Medicaid Expansion Launch, Higher Reimbursement Rates for BH/IDD Providers

Author: Jessica Hagins

Comment Period for Proposed Rule on Information Blocking Disincentives

Because of its commitment to interoperability and information sharing, the NC HIEA closely monitors the 21st Century Cures Act information blocking regulations as outlined by the Office of the National Coordinator for Health Information Technology (ONC). 

On October 30, 2023, the U.S. Department of Health and Human Services (HHS) proposed a new rule detailing its initial plans for holding health care providers accountable for information blocking under the Cures Act. The proposal outlines a set of disincentives for health care providers found to have been engaging in information blocking according to the HHS Office of the Inspector General (OIG).

A formal comment can be made on this proposed ruling on the Federal Register website. Instructions for submitting a comment or contacting the ONC are also found on that page. Written or electronic comments must be received no later than 5 p.m. on January 2, 2024, in order to be considered.

This proposed rule seeks to:

  • Refer a health care provider (individual or entity) determined to have committed information blocking ‘‘to the appropriate agency to be subject to appropriate disincentives.”
  • Establish disincentives for certain health care providers (as defined in 45 CFR 171.102) that are also Medicare-enrolled providers or suppliers.
  • Establish a process by which information would be shared with the public about health care providers that OIG determines have committed information blocking.

The proposals would establish disincentives for certain health care providers through several existing CMS programs, consistent with the Cures Act’s requirement for the secretary to establish disincentives using applicable federal law. OIG enforcement, already in place for other actors as of September 1, 2023, would begin for providers upon finalization of this proposed rule.

We encourage your organization to review the information blocking rules and determine how best to comply with them, to the extent the rules apply to your organization.

NC HealthConnex will continue to facilitate, and not inhibit, participants’ exchange of electronic health information in compliance with information blocking prohibitions. The NC HIEA remains steadfast in its commitment to refrain from engaging in any practice that we know or should know is likely to interfere with, prevent or materially discourage access, exchange or use of electronic health information via NC HealthConnex unless we have a good-faith basis to believe an exception applies

The NC HIEA will be participating with Civitas Networks for Health in providing comments. If any participating NC HealthConnex providers have comments, please send them to us by December 20, 2023 at with the subject “Comments on Proposed Ruling.”


NEW Resources to Help Providers Educate Patients on Privacy and Security While Using Telehealth Services

Last month, the Office for Civil Rights (OCR) at HHS released new documents to help providers educate patients on the privacy and security of their protected health information (PHI) while using telehealth services. These new resources explain the risks to their PHI when using telehealth and steps to take to reduce these risks.

Providers are not required by HIPAA Rules to provide this education; however, it is helpful for supporting the ongoing use of telehealth services, especially for those who may have trouble accessing in-person services. Assuring patients that their PHI will be kept private and secure can make patients feel at ease and improve communication during telehealth visits.

The first resource to help providers is “Educating Patients about Privacy and Security Risks to Protected Health Information when Using Remote Communication Technologies for Telehealth.” 

The resource provides suggestions for discussing:

  • Telehealth options offered
  • Risks to PHI when using remote communications technologies
  • Privacy and security practices of remote communication technology vendors
  • Applicability of civil rights laws

The second resource provided by OCR, “Telehealth Privacy and Security Tips for Patients,” provides recommendations for patients to implement to protect their PHI, including:

  • Conduct the telehealth appointment in a private location
  • Turn on multi-factor authentication if available
  • Use encryption when available
  • Avoid public Wi-Fi networks

Additional guidance about the Privacy RuleSecurity Rule, and Breach Notification Rules can be found on OCR’s website. You can also read more about the NC HIEA’s security and privacy policies regarding protecting health data.


Medicaid Expansion Launches on December 1 in North Carolina

Beginning Dec. 1, 2023, more people can get health coverage through NC Medicaid. The N.C. Department of Health and Human Services received final federal approval in October from the Centers for Medicare & Medicaid Services to launch Medicaid Expansion. NCDHHS has been working with federal partners since August to push the approval through.

"We are grateful to our federal partners for their close partnership and this final approval enabling hundreds of thousands of people the health care coverage they have been waiting for," said NCDHHS Secretary Kody H. Kinsley. "North Carolina is now well on our way to launch Medicaid expansion, and on Dec. 1, about 300,000 people will automatically be enrolled in full coverage."

Medicaid will cover people ages 19 through 64 years with higher incomes. North Carolinians may be able to get health care insurance through Medicaid even if they didn’t qualify before. Most people will be able to get health care coverage through Medicaid if they meet the criteria below:

  • Live in North Carolina
  • Are age 19 through 64
  • Are a citizen. Some non-U.S. citizens can get health care coverage through Medicaid.
  • Have a household income that is below 138% of the federal poverty level. That’s about $20,000 for a single adult or about $34,000 for a family of three.

NCDHHS has launched a new website with information about the expanded eligibility for NC Medicaid, including a toolkit of resources for organizations to spread the word to their communities.

Residents can apply for Medicaid online at They can also submit a paper application or apply in person at their local Department of Social Services (DSS). Applications may take up to 45 days to process. Incomplete applications may take longer.

Providers who use state funds such as Medicaid and the State Health Plan are required to be connected to the state-designated health information exchange, NC HealthConnex. You can learn more about how to connect on our website or talk to one of our outreach specialists by calling 919-754-6912 or emailing us at


Behavioral Health Providers Will Receive Higher Reimbursement Rates from NC Medicaid

Providers of mental health, substance use disorder and intellectual/developmental disability related services will be receiving higher reimbursement rates for some services beginning January 1, 2024.

Last month, the N.C. General Assembly passed the Current Operations Appropriations Act of 2023, which appropriated $220 million in recurring funds to increase Medicaid reimbursement rates for these services.

The Divisions of Health Benefits and Mental Health, Developmental Disabilities and Substance Use Services analyzed which services were priorities for the increases and what forms the increases might take and calculated how to fully allocate the available funds. These allocations are available on the NCDHHS website.

New funding is available for certain services, while others are seeing an increase in reimbursement for listed services. Some services will not see any increase in reimbursements.

Contact for more information. Standard Plan PHP contact information is available on the NC Medicaid Health Plan Contacts and Resources webpage.


Employee Spotlight

Anita Valiani

Health Analytics and Outbound Services, Lead

Anita joined the NC HIEA in July 2023. She works with technology partners and other key stakeholders to develop robust data management practices across systems. With a strong background in public health, she focuses on bringing the NC HIEA and public health systems together to help improve services for all North Carolina residents.

Anita previously worked for more than 10 years at NCDHHS as a surveillance epidemiologist working with communicable diseases. She enjoys bringing technological advances to how health care data is handled and to bridge data gaps for improved insights.

Anita is a Florida native but enjoys all the seasons in North Carolina. Her husband and two girls like exploring new restaurants in the Triangle and visiting the coastal areas.


Connex Kudos:

“The partnership with NC HealthConnex has improved our ability to engage our members. Using data from the NC HIEA, our care managers were better able to connect to high-risk members for critical follow-up during the transition to managed care.” - Kelly Crosbie, Former Chief Quality Officer, NC Medicaid