Cuts to Medicaid reimbursement set to go into effect Wednesday in North Carolina

RALEIGH, N.C. (WTVD) -- North Carolina Medicaid will institute a 5% cut in reimbursement rates for providers starting Wednesday, citing funding shortages.

"(NCDHHS) and North Carolina Medicaid remains short on the amount of money that it needs in order to run the program as we know it. What we intend to do then is to implement the rate cuts (Wednesday). Without a cut to Medicaid of five percent, it feels like there's no alternative at this step at this stage. We've been working with our partners, the health plans as well as the individuals who help us run what is called the fee-for-service program, and we have begun programming the system so that for October 1st, providers will get paid less than they would have been paid in September," said Jay Ludlam, Deputy Secretary for NC Medicaid.

"I do worry about over time, providers are going to decide they just can't deal with Medicaid anymore," said Jenny Hobbs, a mother of four.

It's a concern shared by Lisa Poteat, CEO of the advocacy organization The Arc of NC, which works with people who have intellectual and developmental disabilities.

"We already have trouble finding doctors who will accept Medicaid and have the expertise to support people with intellectual and developmental disabilities who often have combined medical issues that need some specialized care. It's hard to find those doctors. It's hard to find those specialists. This will affect our hospitals across the state, and especially rural hospitals will be affected," Poteat said.

Hobbs' two youngest children have medical issues that require ongoing care and utilize Medicaid.

"These are the people in our community that need help the most. And to sort of abandon them when they're relying on us to help them is like the worst form of cruelty," Hobbs said. She also serves as Board Chair for the advocacy organization Advocates for Medically Fragile Kids NC.

Beth Messersmith, who serves as State Director for the advocacy organization MomsRising, said she's heard concerns from members about the potential impacts.

"There's a tremendous impact on families, especially folks in rural communities, and particularly families with kids with disabilities. We're talking about life-saving access. So there's a tremendous amount of anxiety for folks right now," Messersmith said.

The cuts come as Republican leadership in the State House and State Senate remain engaged in negotiations over the budget over several issues, among them funding for a new children's hospital in Wake County and rural health investments.

"We can't treat health care access as a political football. This is the ability for children to thrive, to grow up strong and healthy. It's the ability for parents to be able to stay in the workforce," said Messersmith.

Republicans have disputed whether the cuts are necessary. Lauren Horsch, who serves as the Deputy Chief of Staff for Communications for Senate President Phil Berger, wrote:

"Gov. Stein and his health department can reverse the proposed cuts now, but refuse to do so. There is no need to make these hasty, politically motivated cuts now. Since this summer, the Senate has been in favor of funding the Medicaid rebase at the amount recommended by the General Assembly's nonpartisan fiscal staff. Last week, the Senate passed the Healthcare Investment Act, which included additional funding for the Medicaid rebase and previously promised support for other critical healthcare needs across the state."

In a statement, a spokesperson from Stein's Office wrote:

"Governor Stein continues to urge the General Assembly to put North Carolinians' health over their political disputes. Governor Stein and DHHS have identified cuts that can be reversed if the legislature comes back in October and funds Medicaid."

A spokesperson for Speaker Destin Hall's Office did not respond to a request for comment.

"What you will see tomorrow is that the program remains the same. We offer the same benefits. We offer the same health plans, but providers themselves will get paid less for doing the same work. And for that reason, we would anticipate that providers who participate in Medicaid support the program will potentially, over time, start seeing potentially fewer Medicaid members. And over time, we would anticipate some providers to not continue to participate in the Medicaid program and pull out entirely, though we don't necessarily anticipate that tomorrow. I think we all are still looking to the legislature to appropriate the funding that they've agreed is needed, but haven't been able to appropriate yet," Ludlam said.

Ludlam cited projections, stating he does not believe NC Medicaid will need to institute any additional rate cuts through the remainder of the year.