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Health Care

Court of Appeals rules on a western CON fight

With the House and Senate providing the crossover crunch this week and last that didn’t happen in early May, it’s been difficult for the other branches of government to get a word in edgewise. But the state Court of Appeals has certainly tried, via a couple of business-related decisions. The...

By Ray Gronberg

June 23, 2025

UNC Health sues Humana and Aetna over Medicare drug reimbursement cuts

UNC Health has sued two of the country’s top health insurers, seeking to recoup alleged shortfalls in Medicare Advantage reimbursements. Lawyers for the Chapel Hill-based health system filed complaints against Humana and Aetna in a Winston-Salem federal court on June 10. Both lawsuits allege the insurers “improperly and unilaterally” shortchanged UNC Health in reimbursements...

By Ray Gronberg

June 17, 2025

An impasse with CVS Caremark?

State Treasurer Brad Briner and his aides say the State Health Plan’s relationship with its pharmacy benefits manager, CVS Caremark, has “reached an untenable impasse.” Things have deteriorated to the point that the plan’s management is “evaluating its options to recover money owed and to determine its future relationship with Caremark,”...

By Ray Gronberg

June 6, 2025

UNC and ECU discord threatens NC Care

Back in 2023, legislative leaders touted their desire to use part of the state’s Medicaid-expansion bonus to fund a new healthcare collaboration between UNC Health and ECU Health. That year’s budget bill authorized spending up to $420 million on the so-called NC Care initiative, and actually appropriated the bulk of...

By Ray Gronberg

May 21, 2025

Strategy uncertain for reconciling PBM bills

With the House having already passed its bill to regulate pharmacy benefit managers, the Senate is on track to vote early next week on its own competing version. Senate Rules committee members agreed Thursday to send Senate Bill 479, the so-called SCRIPT Act, to the floor. That sets up a...

By Ray Gronberg

May 2, 2025

PBM bill clears House

House members voted 106-9 on Tuesday to pass their chamber’s version of a bill that would put some new restrictions on pharmacy benefits managers like CVS Caremark. Included in House Bill 163 is a ban on spread pricing, the practice of a PBM billing insurers for a drug anything else...

By Ray Gronberg

May 1, 2025

Berger on the children’s hospital

The Senate’s budget, passed on Friday, contains $638 million in additional state spending for the new children’s hospital the UNC and Duke health systems are planning to build somewhere in the Triangle. Counting prior appropriations, this will bring the total state subsidy for the project to $855 million. And if...

By Ray Gronberg

April 18, 2025

PBM update

The Senate’s getting into the pharmacy benefits manager game. On Thursday, the chamber’s Health Care committee endorsed Senate Bill 479, which on its face is an alternative to the House’s approach the last couple of sessions to the quarrels over PBMs and their role. Notably, the Senate bill omits a...

By Ray Gronberg

April 11, 2025

House tries again on PBMs

The House is mounting a renewed effort to put some restrictions on the business practices of the pharmacy benefit managers that operate in North Carolina. House Bill 163 got a favorable report Tuesday from the House Health Committee. It needs further screenings by the chamber’s Regulatory Reform and Rules committees...

By Ray Gronberg

April 2, 2025

Senate health bill passes

Senators have sent the House their latest attempt to reduce healthcare costs. Senate Bill 316 cleared the chamber Thursday on a 46-2 vote, 10 days after its initial rollout by the chamber’s leadership. Along the way, sponsors rolled into it the provisions of Senate Bill 315, a parallel measure that...

By Ray Gronberg

March 28, 2025

Health insurance

It’s looking like House and Senate leaders aren’t on the same page about how to go about regulating health insurers’ use of prior authorization for treatments to control medical costs. House Rules chair John Bell, R-Wayne, and other GOP members from the chamber on Tuesday rolled out House Bill 434,...

By Ray Gronberg

March 19, 2025

Chambers gear up for healthcare cost push

Senate leaders are signaling that they’re going start pushing a pair of health-related bills through the chamber this week. They’ve scheduled hearings on Wednesday in the chamber’s Health Care committee on newly introduced Senate Bills 315 and 316. Both were filed on Monday. And both have the same set of...

By Ray Gronberg

March 18, 2025

Cabarrus County’s dueling hospital projects

Novant Health says its $336.4 million proposal to build a 50-bed acute-care hospital on the southwestern outskirts of Kannapolis is partially intended to bring some much-needed competition to the region health-care sector. Its construction would offer “a vital alternative to Atrium Health,” which is currently “the sole provider of acute...

By Ray Gronberg

March 4, 2025

Duke and Novant collaboration

Only about a month after entering a joint venture with UNC Health on a new children’s hospital, Duke Health says it and Novant Health are going “to develop new campuses across North Carolina that will expand access to affordable, high-quality care.” In a joint news release on Monday, Duke and...

By Ray Gronberg

March 4, 2025

A battle for beds in Cabarrus County

Medical providers have filed new certificate-of-need applications that could result in almost $772 million of capital spending if all their projects get approved by the N.C. Department of Health and Human Services. Four projects out of the 27 would account for the bulk of the cost: Novant Health wants to build...

By Ray Gronberg

March 3, 2025

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