Advocacy Update
NCASCA Legislative Update 4-16-21

The legislature returned from Easter break this week and legislation started flying.

Legislation that concerns NCASCA continues to further grow. The focal point this week was the Health Information Exchange (HIE) issue. Currently, ASCs must be online by June 1st of 2021. That deadline is not likely to hold because the House is poised to extend it until June 1st, 2022. 

Some traction was gained on NCASCA's request to be exempted from the HIE requirement. We have shared information about our centers not being included in the Federal Guidelines, costs and potential duplication. The bill that seems to be the vehicle for this issue is HB 395. While this bill entered hearing last week, no vote was taken and it is expected to reappear next week.

HB 468, Establish Surgical Technology Standards, is scheduled to be heard in the House Health Committee next week. The NCASCA Legislative Team is going to work with the sponsor to ensure that this bill is similar to the desired bill that was signed off on during the last long session.

Certificate of Need legislation remains prolific. HB 410 in the House and SB 309 in the Senate seek to repeal the CON laws in full. SB 506 is a more targeted approach. Both Senate bills are in the Rules Committee and NCASCA is keeping a sharp eye on them. SB 506 aims to exempt ASCs from CON review in counties with a population of 100,000 or more under certain circumstances. A complete repeal is not likely to happen. What is more probable is that some modifications will be made. Modifications can include restricting the ability to "sit" on a CON and an increase on the equipment threshold exemption.

Finally, there are several transparency bills that are of concern. These include SB 505 and SB 415.  We are monitoring these bills very closely. These are "surprise billing" bills that have been introduced around the country.

Please contact me with any question you may have on these or other issues of concern to the NCASCA. 

Thank you, 
Dick Carlton

Richard H. Carlton

Law Office of Richard H. Carlton, PLLC

NCASCA Legislative Update 3-12-21

The NC General Assembly is in full swing as more and more legislation is introduced each day. The Governor and the Legislature just came to an agreement on a bill that would reopen the public schools. That comes as a big relief to many.

Of direct interest to NCASCA are the issues of the Health Information Exchange and Certificate of Need.  The Association has prepared one page talking papers on each of these issues, and they are being given out to the appropriate decision makers on these issues.

On HIE we have had productive discussions with leaders of both the House and Senate.  The Senate already has a filed bill (SB 226) to extend HIE Participation and Enforcement until June 1, 2022.  We are still working both sides for a possible exemption.  That is more difficult, but we at least have to have this extension now.

On the Certificate of Need front, we expect the annual legislation to repeal all or some of the parts of our Certificate of Need laws.  We have made it clear that our Association is against such broad action.  There are minor adjustments that can and should be made to the CON laws, and we are telling those leaders that we want to be part of those discussions in the days to come.

The Senate has introduced two bills that would allow the deductibility of those expenses related to loans received under the Cares Act.  

The Bill filing deadline in the House is April 27 and April 6 in the Senate.

Thank you, 

Dick Carlton
NCASCA Lobbyist

NCASCA Legislative Update 6-12-20

The Legislature is in full swing in Raleigh for the traditional second year short session of the 2019-2020 Session. They are trying to conduct business in the very trying circumstances of COVID-19. They would like to wrap up business before July 4, but adjournment time is never certain in this business.

COVID-19 cases continue to rise in North Carolina, but the State reacted early and is well prepared to meet this health challenge moving forward. Hopefully there will be no more shut downs because the pandemic has already had a profound effect on on the Ambulatory Surgical Center industry, but we worked with the Governor's Office to get back to business as soon as practical.

On the health care legislative front, the Senate is poised to pass SB 730.  This is a very emotional bill that would give the patient the right to have a designated person with him or her while in the hospital even during the pandemic crisis. The Health Care association is against this bill because of health concerns in the hospital setting. They feel the hospital is in the best position to make these visitation rules and circumstances change daily. This is truly a tough issue.

SB 808 has the short title of Medicaid Funding Act. The main section of this bill appropriates funds for the medicaid transformation from a fee for service to a managed care organization system.  

Our association is continuing to monitor all health related bills because some members of the Senate still would like to see some action on repealing Certificate of Need laws this session in some form or fashion. To date no such language has been inserted into any legislation.

NCASCA Legislative Update 7-26-19

This week, State Treasurer Dale Folwell re-opened the enrollment period for providers after releasing an updated proposal for the State Health Plan.  Back in June, the State Treasurer was met with resistance when he put forth a plan to slash reimbursement across the board for all provider types and is under pressure to show an effort to recruit providers to serve the plan participants. 

The new proposal limits medical providers in urban areas to 196% of Medicare, up from the originally proposed rate 182%.  Proposed rural provider rates average 200% of Medicare, also up from the original proposed rate of 178%.

Centers have until August 5th to decide if they will participate in the network and return a contract. Providers not returning a contract will be out-of-network as of January 1, 2020.

NCASCA will keep you updated on this issue.  If you have questions, contact NCASCA legislative director Dick Carlton at [email protected] or Meghan Millard at the NCASCA office at [email protected]  

NCASCA Legislative Update 6-28-19

NCASCA earned a hard-fought victory this week when the North Senate Health Committee agreed to remove CON repeal language from SB361. Members of our association came to Raleigh to speak against the repeal of CONS for ASCs in Senate Health Committee.  Subsequently Senator  Krawiec amended SB361 on the floor to take out ASCs from CON repeal.  It passed and the bill is now in House Health Committee. 

At the same time, NCASCA became aware that CON repeal for ASCs was put in HB126.  Senator  Perry was instrumental in taking it out in House Health Committee.  The repeal of other groups including dialysis is still in that bill.

At this point in session, CON repeal seems unlikely given the active bills in consideration.  However, this legislative session has highlighted the need to be vigilant and to educate legislators about ASCs. 

NCASCA calls on members to get to know their state legislators, to host them at your center with a facility tour, and to meet with them at their offices in Raleigh.  Also, encourage your physicians to contribute to the NCASCA PAC - remember personal check only. 

The work has just begun!

For more information, contact NCASCA legislative director Dick Carlton at [email protected] or Meghan Millard at the NCASCA office at [email protected]  

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