This has been a very active legislative session for the North Carolina Ambulatory Surgical Center Association ("NCASCA"). The following is a summary of the bills of interest to NCASCA.

On March 26, Governor Roy Cooper signed House Bill 76, Access to Healthcare Options, into law.  The legislation will expand Medicaid, which is expected to provide health coverage to over 600,000 people across North Carolina and bring billions in federal dollars to the state. 

The bill also provides for increase Medicaid reimbursements to hospitals through the Healthcare Access and Stabilization Program (HASP), and increases hospital assessments to provide funding for the NC Health Works coverage and the HASP program. 

Certificate of Need (CON) reform has taken a dramatic turn this year with unfortunate results for ambulatory surgery centers.

Yesterday, the Governor, the Speaker of the House and the Senate President announced an agreement to expand the North Carolina Medicaid program during the State of the State address. What wasn’t said was that the legislative package to implement the expansion will also include the repeal of the Certificate of Need for ambulatory surgery centers located in counties over 125,000 in population.

The North Carolina General Assembly returned to Raleigh on January 25 to begin their work for the year. The most important issue for NCASCA is the potential repeal of the Certificate of Need (CON) laws. Our association has worked hard to prevent repeal for the last several years.

Late last year, there was a great deal of talk about tying Medicaid expansion in with CON reform in a give and take. This year, the House has wasted no time passing HB 76 out of committee. The bill was sent to the floor and passed 92-22. The bill is now in the Senate. 

As many of our members are aware, the Governor has for years sought Medicaid expansion in North Carolina. Up until now, he has met strong opposition from the State House and Senate. 

However, the leadership in the General Assembly has recently indicated a willingness to expand Medicaid. The State Senate, meanwhile, wants to pair Medicaid expansion with other health reforms, such as repealing the Certificate of Need laws. The House of Representatives has historically been against Certificate of Need repeal.

The North Carolina Healthcare Association (NCHA), in an attempt to move Medicaid expansion, said it would agree to some repeal of the Certificate of Need laws. This would include granting exemption from that law to ambulatory surgical centers, effective five years from the Medicaid expansion go-live date.