The General Assembly has adjourned until October 20 without reaching agreement on legislation to stop the October 1, 2025, Medicaid rate cuts recently announced by NCDHHS. Read more about the origin of these cuts.

Medicaid health plans (both Standard Plans and Tailored Plans) are called upon to implement numerous fee schedule changes each year; all subject to a 45-day implementation window. The plans are considering a request from NCMS and other associations to forestall implementing these cuts during the 45-day window to allow time for further consideration of solutions that might make the cuts unnecessary. Unless a solution is found before the 45-day window closes, the plans will be required to recoup the difference for all claims paid after October 1. During that 45-day window, the General Assembly is scheduled to reconvene, at which time they might address the cuts.

NCMS and its specialty society partners remain committed to working with the North Carolina General Assembly, the Stein Administration, and you to avoid these cuts and their erosive effects on the health infrastructure we all rely on.

THANK YOU to all physicians and PAs who have spoken directly with their representatives, the Governor’s office, and NCDHHS officials. It is important to continue contacting legislators until the 45-day window has closed, letting them know the impact these rate cuts will have on your patients and your practice.   

As a reminder, cuts that are effective October 1 include:

• 3% rate reduction for providers of most Medicaid services
• 10% rate reduction for acute care hospitals, nursing homes, psychiatric residential treatment facilities, and autism therapy services
• 8% rate reduction for intermediate care facilities
• Medicaid administrative cuts, including ended contracts, halted projects, and reduced compliance monitoring
• Healthy Opportunities Pilot (HOP) program terminated

What you can do:

Contact your lawmakers, NCDHHS, and the Governor’s Office immediately. Every call and email matters in this critical moment.

YOUR MESSAGE: “I urge you to approve additional Medicaid funding to prevent the multimillion-dollar shortfall. North Carolina’s access to care depends on your immediate action.”

Feel free to share personal, concrete examples of how these rate cuts will impact you and/or your practice. Be sure to thank everyone for their time and attention to this problem.

Find your Representative or Senator: ncleg.gov/findyourlegislators

Contact DHHS: ncdhhs.gov/contact 

Contact the Governor’s Office: governor.nc.gov/contact/contact-governor-stein