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Public Health Payment Programs

In general, the DPH APA rules for public health payment programs were originally adopted in 1981 and need to be modified so that programs no longer in effect are removed. Also, the rules are proposed for amendment to align with Medicaid reimbursement policies, as the public health payment programs are being incorporated into the new Medicaid multi-payer claims processing system. These alignments include paying claims based on date of service rather than on the date a claim is receive, reimbursing inpatient services based on number of admissions versus a per diem basis, requiring pharmacies to bill 3rd-party payers before billing the public health payment program. The proposed amendments also aligns the NC Early Intervention services with federal regulation by incorporating all subsequent editions and amendments, will allow the program to always be current with federal requirements.

A public hearing was held on September 16, 2013 at 2 p.m. in the Cardinal Room, located at 5605 Six Forks Road, Raleigh, NC 27609.

Proposed Rule: Payment Programs Rule Changes
Fiscal Note: Fiscal Impact
Federal Certification: N/A
Adopted Rule: N/A

Public Comments

The public comment period was from August 15, 2013 through October 14, 2013. Comments for this rule will not be accepted after October 14, 2013.

Additional Links

Procedure for Subjecting a Proposed Rule to Legislative Review