RALEIGH, N.C. – North Carolina providers secured an important win last week when both chambers of the General Assembly approved a one‑year extension of the state’s Medicaid rate floor, moving its expiration from June 30, 2026, to June 30, 2027. House Bill 696 was signed into law by Governor 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 legislation, with significant support from our team, set reimbursement at 100% of the lesser of a supplier’s usual charge or the maximum allowable Medicaid fee‑for‑service rate. The five‑year protection, effective July 1, 2021, ensured that Medicaid Managed Care organizations could not cut DMEPOS reimbursement below sustainable levels.
The AAHomecare team worked closely with ACMESA’s lobbyist, Dick Carlton, and Hampton Billups with Checkmate, retained by Aeroflow. Their collaboration underscores the power of coordinated advocacy.
This progress in North Carolina is part of a broader national push to strengthen Medicaid reimbursement protections. Our team also played a key role in securing a 7.5% Medicaid rate increase for DME in Florida in 2023 with FAHCS and supported the introduction of rate stability legislation in other other states. These efforts are a key objective for our Payer Relations team.
CMS Broadens Stay‑of‑Enrollment Actions
WASHINGTON, D.C. – Stay of enrollment is a preliminary action CMS can take on non-compliant suppliers. Instead of revoking or deactivating supplier numbers, for certain scenarios, suppliers can be put on a stay of enrollment which will just pause their enrollment providing up to 60 days to correct the non-compliance.
The stay was first implemented for DMEPOS suppliers in 2024 for specific scenarios such as failure to respond to revalidation request or timely reporting of address changes.
Beginning on May 18, CMS will apply additional scenarios where stay of enrollment can be applied:
- Liability insurance and surety bond cancellations
- Site visit non-compliance determinations
- Failure to respond to development requests within 30 days for revalidations or changes to information
Providers can find additional information in the updated MLN Matters Article.
