On Wednesday, Governor Josh Stein announced that North Carolina would restore reimbursement rates for Medicaid providers.
Earlier this year, the Republican-controlled legislature failed to agree on a comprehensive state budget. Instead, the state legislature passed a stopgap budget in July, which allocated $319 million less than Medicaid is projected to spend this fiscal year, just over .
To close that gap, NCDHHS implemented cuts to reimbursement rates: 3 percent across the board with some services cut even more, beginning October 1.
As we wrote in October, this cut may not sound like much. But for dental providers already operating on thin margins, it’s significant. Medicaid dental rates in North Carolina have not been updated in more than a decade. Many practices already struggle to break even.
Since October, however, a series of court rulings have required the state to reinstate reimbursement levels for certain services. Governor Stein then directed DHHS to restore rates for all services to September 30 levels.
While the reversal provides short-term relief to providers and patients, the underlying financial problems remain. DHHS no longer has viable mechanisms to manage the funding gap alone. Payments will continue only as long as there is money, which is expected to run out this spring. Stein underscored the urgency, telling reporters:
“The General Assembly must act to fully fund Medicaid and protect health care for more than 3 million North Carolinians… Medicaid still does not have enough money to get through the rest of the budget year.”
If the $319 million funding gap is not closed, DHHS Secretary Devdutta Sangvai says, “services could be eliminated. Providers could be left waiting for payments that may never come. Clinics and practices, especially those in rural areas where so many residents rely on Medicaid, could be forced to lay off staff and stop serving patients or simply close their doors altogether.”
For now, Medicaid providers will receive their previous rates. The legislature is set to reconvene on Monday, but it remains to be seen if the chambers will agree on a budget that provides Medicaid with its needed funding. If they don’t, North Carolina’s oral health infrastructure remains at risk.
If you are a patient, provider, or advocate, your voice matters. Share your story, talk to your legislators, and join NCOHC in our mission to ensure that every North Carolinian can access the oral health care they need and deserve.