Connection Deadline FAQs

The N.C. Health Information Exchange Authority is providing information about legislative requirements that is accurate to the best of our knowledge. Health care organizations and providers should continue to monitor changes to relevant laws implemented by the N.C. General Assembly, which supersede any information from the NC HIEA.

Last updated Sept. 20, 2022

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Jan. 1, 2023, is the deadline to connect to NC HealthConnex and submit data for all health care organizations that receive state payments (e.g., Medicaid, State Health Plan) for treating patients.

The condition of payment written in statute, which requires health care organizations that receive state funds (e.g., Medicaid, State Health Plan) for treating patients to connect in order to receive payments, has been suspended. A report on which health care organizations have or have not connected to NC HealthConnex will be submitted to the N.C. General Assembly in March 2023. Providers may have individual contractual requirements to follow state law and/or connect. Consult your attorney.

The Statewide Health Information Exchange Act does not allow for an extension of the January 1, 2023, deadline. It is a firm deadline.  Signing a participation agreement and actively engaging in the onboarding process with your technical vendor and the NC HIEA demonstrates a good-faith effort to meet the deadline of January 1, 2023.

Presently, there is a large queue of health care providers in active onboarding to complete the connection process. Please continue your active efforts to complete onboarding. Connecting to NC HealthConnex can take up 12 months, depending on your organization’s electronic health records software, the volume of technical connections that must be built and other factors. There are no guarantees of additional time extensions to statutory deadlines, and a report of providers and entities who treat State-funded patients but have not connected to NC HealthConnex will be provided to the General Assembly in March 2022.

Yes. All health care providers subject to the Statewide Health Information Exchange Act who previously  had an October 1, 2021, deadline to connect and submit data now have until January 1, 2023, to  do so.

If your health care organization has not signed a participation agreement with the N.C. Health Information Exchange Authority (NC HIEA), it is highly recommended to begin the process now. For more information, please join one of the monthly How to Connect Calls.

If your organization has executed a participation agreement with the NC HIEA and is already in active onboarding, please be advised that you are expected to continue the technical integration. Failure to continue onboarding efforts will cause your organization to lose its place in the onboarding queue.

If your organization has executed a participation agreement with the NC HIEA but has not started the onboarding process, be advised that the NC HealthConnex technical team will contact your organization when technical discussions are to begin with your practice. Please contact hiea@nc.govwith questions about your organization or if your organization needs additional guidance about instructions provided by NC HealthConnex technical team.

It is imperative that providers, health care organizations, pharmacies and others subject to the Statewide Health Information Exchange Act take immediate steps to connect to NC HealthConnex. The connection deadline of January 1, 2023, has not been delayed or extended, and enforcement of the condition of receiving state funds has only been suspended. In March 2023, the NC HIEA will report to the General Assembly on connection status of providers and offer recommendations on how to begin enforcement of the connection mandate. Executing a participation agreement with the NC HIEA can help demonstrate an organization’s  good-faith effort and intent to comply with the Statewide Health Information Exchange Act.

NC HIEA regards health care organizations that have begun the technical process of connecting to NC HealthConnex to be making good-faith efforts to fulfill the connection mandate. They should continue onboarding or risk losing their place in the queue. NC HIEA also considers organizations that have signed a participation agreement with NC HIEA but are not yet live and submitting data by January 1, 2023, to be making good-faith efforts to connect. As providers are invited to begin the technical connection process, they should be ready to proceed or risk being moved to the back of the onboarding queue.

Early in 2022, the NC HIEA prioritized the queue of more than 5,000 organizations onboarding with NC HealthConnex based on a variety of factors. As a result of these prioritization decisions, onboarding for some providers has been temporarily placed on hold. NC HIEA still considers the organizations put on hold to be making good-faith efforts to follow the HIE Act.

Additionally, if your organization has signed a full participation agreement with the NC HIEA, you can still access data through the NC HealthConnex clinical portal. Reach out to the SAS Help Desk at or 919-531-2700 to request credentials to the web-based clinical portal.

Organizations on hold or in the process of having their connection built can also take advantage of training on how to incorporate the HIE into their workflow. Please see our on-demand training library, or request a training session.

If you are unsure of the status of your project, please email

Health care organizations and providers that have signed a full participation agreement with the NC HIEA can begin using the web-based clinical portal within NC HealthConnex. They do not need to have established their connection to submit data to NC HealthConnex in order to receive credentials. Please note that clinical portal access is not extended to prepaid health plans and local management entities/managed care organizations in these circumstances.

The NC HealthConnex Clinical Portal is a secure, standardized electronic system through which providers and pharmacies can share important patient health information across disparate electronic health record systems and pharmacy management programs. Clinical portal users can search for patients, view demographic and clinical information, and exchange messages and patient records with other providers.

With access to critical information, such as laboratory values, changes in level of care, and treatment history, providers are able to make more informed decisions based on the most up-to-date and accurate clinical data. Use of a health information exchange provides visibility into a patient’s medical record and can help improve patient care and patient safety by enabling more effective care to patients, improving treatment and medication adherence and reducing errors which contribute to unplanned admissions to hospitals.

Yes. Providers and organizations that are subject to condition-of-payment connection mandate in N.C. Gen. Stat. § 90-414.4 are not exempt from the mandate because they do not presently maintain an electronic health record. To connect and submit data to NC HealthConnex, a provider or organization must have an EHR that is minimally capable of sending HL7 messages, version 2 or higher. The NC HIEA is working with more than 200 electronic health records vendors, including vendors submitting data. We encourage you to procure an EHR as soon as you are able so that you can begin the connection and onboarding processes. Connecting to NC HealthConnex can take up 12 months, depending on your EHR software.

At this time, the NC HIEA is conducting a pilot with pharmacies for the initial development and integration of pharmacy data into NC HealthConnex. The NC HIEA worked collaboratively with pharmacy stakeholders and the National Council for Prescription Drug Programs (NCPDP) to develop technical specifications that will be utilized and finalized in the pilot projects. This effort is one of the first of its kind nationally – to aggregate dispense data with clinical data to provide a more complete health record for North Carolinians at the point of care. The NC HIEA views pharmacies that have signed participation agreements as acting in good faith to meet the January 1, 2023, deadline, and no additional action needs to be taken at this time.

No. An in-network provider with State Health Plan for Teachers and State Employees that renders health care services, including prescription drugs and durable medical equipment, and does not connect to NC HealthConnex is prohibited from billing the State Health Plan or plan members more than would be billed if the provider was an NC HealthConnex Participant. See N.C. Gen. Stat. § 90-414.4(b1). 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

The Statewide Health Information Exchange Act gave the N.C. Department of Health and Human Services the authority to grant temporary hardship extensions to classes of providers for whom acquiring and implementing an electronic health record (EHR) system and connecting to the HIE Network would constitute an undue hardship. See N.C. Gen. Stat. 90-414.4(a3). The N.C. Department of Health and Human Services had statutory authority to grant such extensions through December 31, 2022.  The change of the connection deadline to January 1, 2023, has effectively mooted the hardship extension process.

Providers and entities with questions about the hardship extension process should contact the DHHS Division of Health Benefits Provider Ombudsman at

Now. The extension of the connection deadline until January 1, 2023, allows additional time for health care providers to complete their technical onboarding process without being out of compliance with the HIE Act. However, please note that more than 5,000 facilities are in onboarding at this time. Providers should continue to work diligently to connect to NC HealthConnex. The NC HIEA will provide the General Assembly with a compliance-related report on providers' and organizations' connection efforts by March 2023.