Tag: North Carolina
North Carolina extends DME rate floor, but long-term funding concerns grow nationwide
August 28, 2026By Theresa Flaherty, Contributing Writer
RALEIGH, N.C. - A three-year extension of the DME rate floor for North Carolina Medicaid provides well-earned relief for providers, but industry stakeholders say reimbursement pressures continue to mount nationwide.
The North Carolina General Assembly has approved a state budget that extends the rate floor for Medicaid for an additional two years through June 30, 2029. In May, Gov. Josh Stein signed HB696 into law, providing an initial one-year extension through June 30, 2027.
“Our...
ACMESA secures extension of Medicaid fee schedule floor
July 8, 2026HME News Staff
RALEIGH, N.C. – The North Carolina General Assembly has approved the state budget, securing an additional two-year extension of the Medicaid fee schedule floor, the Atlantic Coast Medical Equipment Services Association (ACMESA) reports. The protection will now remain in effect through June 30, 2029. “This positive outcome was only possible through the hard work, relentless dedication, and strategic collaboration of our provider network, advocates, and lobbyists,” ACMESA said in...
North Carolina extends Medicaid rate floor
May 13, 2026HME News Staff
RALEIGH, N.C. – Both chambers of the North Carolina General Assembly have approved a one‑year extension of the state’s Medicaid rate floor, moving its expiration from June 30, 2026, to June 30, 2027, according to a bulletin from AAHomecare. House Bill 696 was signed into law by Gov. Josh Stein on April 30. This extension builds on a success for North Carolina providers first achieved in 2021, when the state enacted Senate Bill 594 to establish a Medicaid rate floor for DMEPOS. That...
NC governor orders state to restore Medicaid reimbursement
December 15, 2025HME News Staff
RALEIGH, N.C. - Gov. Josh Stein is directing the North Carolina Department of Health and Human Services (NCDHHS) to restore Medicaid reimbursement rates to Sept. 30, 2025, levels. The governor’s office says the legislature’s failure to fully fund Medicaid forced cuts to the program in October and the months-long budget stalemate between the legislative chambers has resulted in a wave of litigation against the state. It says recent court orders have...
NC expands Medicaid program
December 5, 2023HME News Staff
RALEIGH, N.C. – About 600,000 people living in North Carolina aged 19 to 64 are now eligible for health coverage through the Affordable Care Act’s Medicaid expansion. North Carolina is the fourth state to expand Medicaid coverage during the Biden-Harris administration, joining Missouri, Oklahoma and South Dakota. “Medicaid Expansion is the working families bill of the decade for North Carolina, and its impact on peoples' health, combating the opioid crisis, saving rural hospitals...
Providers in NC to receive rate increase
November 1, 2023HME News Staff
RALEIGH, N.C. – HME providers in North Carolina will receive a rate increase for 13 products that equates to about $3.2 million more for their bottom lines over an eight-month period.
Members of ACMESA’s Medicaid and legislative committees and AAHomecare’s payer relations team have lobbied for the increase for two years, following the state’s decision to discontinue a 5% rate increase related to the COVID-19 pandemic.
“ACMESA is thankful for the...
NC Medicaid extends rate increase
September 16, 2021HME News Staff
CHARLOTTE, N.C. – North Carolina Medicaid has agreed to extend a 5% rate increase for home medical equipment for two months, until Nov. 30, according to AAHomecare. Medicaid officials have also agreed to meet with ACMESA to discuss extending the relief beyond Nov. 30. “North Carolina providers are elated that NC Medicaid elected to extend the 5% Covid relief,” said Craig Rae, ACMESA president. “In light of the continued cost increases we’re facing, this helps protect...
North Carolina implements Medicaid rate floor
July 8, 2021HME News Staff
RALEIGH, N.C. – North Carolina Gov. Roy Cooper on June 29 signed S594, a bill that creates a rate floor for durable medical equipment, ACMESA and AAHomecare report.
Per the legislation, reimbursement for DME will be set at 100% of the lesser of the supplier’s usual and customary rate or the maximum allowable Medicaid fee-for-service rates for DME and supplies, orthotics and prosthetics.
The legislation, which went into effect July 1, protects rate floor provisions for...
North Carolina rate protects DME
July 7, 2020HME News Staff
RALEIGH, N.C. - North Carolina Gov. Roy Cooper on July 2 signed Bill 808, including a provision creating a rate floor for durable medical equipment.The bill, a year in the making by groups like ACMESA and AAHomecare, prohibits managed care organizations from setting rates below the state's Medicaid fee-for-service rates for DME.“ACMESA's strong relationship with AAHomecare enabled us to learn from the problems experienced in other states as they rolled out their MCO programs,” said Craig...
Managed Care, N.C.: Providers use break to address concerns
January 6, 2020Theresa Flaherty
RALEIGH, N.C. - HME providers here got a reprieve in November when North Carolina suspended its transition to Medicaid managed care after Gov. Roy Cooper vetoed a $502 million bill to fund it.
The program was slated to begin Feb. 1, with many providers already enrolled with one of the five managed care plans.
“At this point, they are not cancelling the contracts, but they are suspending related activities,” said David Chandler, director of payer relations for AAHomecare. “They...