Name: State lawmakers make major health care policy announcement
Uploaded: 2023-03-02T10:57:00-0500
Duration: 1321100
Description: Senate leader Phil Berger and House Speaker Tim Moore scheduled an 11 a.m. press conference on an expected health care announcement.

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Senate leader Phil Berger and House Speaker Tim Moore scheduled an 11 a.m. press conference on an expected health care announcement.

So we have come to an agreement on Medicaid expansion And the agreement is that the Senate will modify the houses Medicaid expansion bill. Um we're in the process of doing that, so I don't have the draft at this point, but the new version uh will uh eliminate certificate of need for behavioral health beds uh for chemical dependency beds. It will raise the replacement equipment threshold to $3 million dollars and index that number to inflation. It will increase the threshold for diagnostic centers uh $23 million and index that to inflation. Uh It will eliminate a C. O. N. For MRI's in counties with a population of 125,000 or more. Uh That provision will be effective three years from the first has has payment. Uh It will eliminate C. O. N. For ambulatory surgical centers in counties with a population above 100 and 25,000. That provision is effective two years from the first half payment for both multi specialty and single specialty ambulatory surgical centers. Uh The surgical centers uh that are exempt from C. O. N. Under the provisions will be required to have a 4% charity care requirement for those centers in the in the counties with populations above 100 and 25,000. Uh And there will be an annual reporting requirement regarding the charity care. Hasp will become effective immediately upon enactment of the legislation. Uh Medicaid expansion would be effective only upon passage of the 2023 budget. Uh That is the agreement from a timeline standpoint. Um uh We are we've got staff working on an amendment to the House bill that we will take up in the Senate. I do not know if that will be ready in the upcoming week or not, but we will move with all deliberate speed to move this forward and with that I'll turn it over the speaker and then we'll take your questions. Thank you. Senator Berger. Good morning. This is uh this is a process that has taken quite some time, but it has resulted in a I would submit to you a product that is that is going to do a lot for north Carolinians. Uh Senator Berger did go through the terms that were that were reached the negotiations between the two chambers that have been happening now for for some time and at the end of the day, what we know is we're gonna have a legislation, we're gonna have a policy that is gonna expand access to working north Carolinians that is going to ensure that there is a more robust supply of a lot of these services that is going to result in less cost, but at the same time vitally important to protect access to health care, particularly in our rural areas. One of the balances that we were always concerned about was ensuring that we don't do anything that creates greater disparities and greater access issues to health care in our rural parts of the state and, you know, we have so many communities and counties that are having declining populations. They're having aging populations, populations where the needs are even more acute uh and where those areas where they have truly declining populations, the ability for the local community to supplant or to provide for that is even more challenging. So this is I would submit to you a very balanced way to approach it. It's one that we consulted with stakeholders from around the state, Everyone from, you know, uh hospitals to uh to other health care providers to you name it. Uh folks that, you know, we believe our experts and have of course have varying points of view. And the result of that has been to come up with something that I believe is a very carefully crafted and appropriate balance for where we are in north Carolina and really probably what has really gotten us to where we can get to this point, I would say is probably the hasp the fact that the the has funds are gonna be coming to these communities that are in many ways so much in need. So it really provides a stabilizing factor. The 90 10 match of course does as well. But those things have been game changers that have allowed us in a very fiscally prudent and fiscally responsible way to move forward with expansion and to move forward with C. O. N. Reform, so that we appreciate you being here and I guess we'll take questions at the appropriate time. No Michael. So the expansion is for all practical purposes, a budgetary matter, we've got all sorts of provisions in uh, in our budget that deal with uh Medicaid payments. I mean, for instance, last year we extended tradition Medicaid uh to uh further postpartum care. Uh those folks or many of those folks would likely be eligible in the expansion population. So it just fits with doing that effective with the passage of the budget. I have not talked to the governor. I haven't yet as well. We felt like it was important that we let our let our members know let our health chairs. No, because this has been a process and and go ahead and get the information out, but we'll be either meeting with and talking with the governor today as well. Gary Yeah. Uh enrollment for uh, we um, I mean the bill that came over from the house has an effective date of January one. we've we've not had any conversations about that aspect of the bill, but we're gonna take the house bill, we're gonna put these provisions in uh and we'll work everything else out. We know you've been talking about this. But has there been some, was there some breakthrough that this happened quickly today or yesterday? Because we talked to you folks earlier this week and there seem to still be alive. Well, we've been um, conversing the speaker and I personally, our offices, we've had conversations with with our members. Uh it's been a process that's been ongoing for the last, I'd say four weeks or so. Yeah, it's just when when we've had our gaggles afterwards and I've said we're working on a few other things. This is one of those things that we've been working on, but working on a lot of other great things as well between july and now there was a standoff but of stalling in july what broke that loose. So I don't know if uh if there's any one thing that broke things loose, but I mean it was pretty clear that um that it was going to take some time for us to really get folks comfortable with a lot of aspects of both expansion, the C O N provisions and some other things. I mean, there are still some things that need to be done, but this is this is our agreement uh and I'm very comfortable with it, I think it's a good agreement for the state. Uh It's uh it's something that uh respects the concerns that a lot of folks have had about various aspects of uh both expansion and has and uh and the other provisions. So I think it's just a process And I think you've heard me say multiple times, that if you think about how far we've come over the past 12 months on this issue, I think this is just a continuation of those conversations and I was gonna say on that too, you've also had a lot of discussion between the various stakeholders. I think folks have wanted to sit down and say, Okay, if you do this, what does it practically amount to in terms of the financial sustainability of the, you know, the model of healthcare? And I got to give a shout out to the health, to the health committee chairs in the Senate and in the House. I mean, these folks back here while Senator Berger and I are dealing with a myriad of issues. These folks standing behind us have been working now for months, really drilling down on this issue and trying to find uh, consensus. And so I just gotta say these are some of the most underpaid, overworked folks in state government back here. They've done an amazing job about it. I assume you have. But do you have majority support in both caucuses? So, as for as for the House, we met with our health chairs, we knew coming out of the caucus the parameters of where we wanted to be and where we needed to be. So, we haven't gone back and unveil this to the full caucus just yet. We reached this deal uh, late last night, but put the finishing touches on this morning and felt like we needed to go ahead and get it out there because there will always be speculation and rumor and all that kind of thing. Go and just get it out there and get the details to uh to the public because this is something we can all be very proud of. Can you explain more about why making this type? Why is it as far as currently the primary reason from my perspective has to do with matching it up with other money provisions. And we we generally, I mean from time to time will pass something that uh that deals with uh spending outside of the budget, but it's usually a small one time thing. This this is a recurring situation as far as expansion is concerned, uh will impact various parts of the budget uh and it needs to be coordinated with the passage of of an overall budget because going to be what the version is actually going to look like Or is there still some other, I don't know of any specific negotiations about anything, but obviously we're talking about the high points. There's a lot of detail in for instance, the 4% charity care, there's a lot of detail there as to how do you define charity care, those sorts of things? We've agreed on some language as far as that's concerned. Uh so I mean, I believe that if you take the house bill that came over to us And you add these things to it, that you've got 95% of what the final product is gonna be. I mean, we we've dealt with the things that have generally been the barriers in the past. But I want to follow up on the, on the answer that Senator Berger gave you on the budget. I mean, we're talking billions of dollars here. Right? I mean, it really needs to be a part of the budget and the schedule that uh I remember you look of surprise when I told you our schedule, right, that we would have a budget out of the house before the easter recess And the senators assured me they're gonna pass exactly what we send them in the budget without changes. There you go. There you go. There you go. No, but but but we're so we're gonna have the budget out in a very early period of time. Uh and and the Senate will have its schedule that it goes through. But I see no reason that we won't have a budget enacted, you know, in June and so that's that's the that's the period June 30 is the is the magical date for all of this. So I see no reason, you know that we that we don't get there. Things are moving. Well, I mean, if you look at the cooperation between the House and the Senate, it's probably the best this year. It's been in a in a long time. I mean, think of the serious policy differences that have been, that have been addressed in relatively early. I mean, we're just just just now, March, uh we've dealt with some pretty weighty issues that that have kept this, you know, this General assembly and prior general assemblies here until the, you know, through the fall of the year. So I'm a I'm feeling very positive about things yesterday, baby. Yeah. Yeah. You senator berger, you left a lot of stuff on the table including nurse, say that basically of other things, where do those stand, is that are there gonna be negotiated separately if at all? Uh I continue to be supportive of the Save Act. There have been measures introduced in both the House and the Senate. Uh We will continue to work to address the issue of supply, particularly supply for primary care um needs and the Save Act has provisions that that does a great deal to help. I I can remain convinced that giving 600,000 people a card that says that their health care is going to be paid for uh is uh is going to be somewhat problematic if we don't increase the supply of of of uh of folks that can treat them. We've addressed part of that with the C. O. N. Provision. Uh I remain committed to working towards the other part of it as well. It's not well, it's not part of this deal. That's correct. Obviously, we're talking a lot about the budget here. I assume we're still expecting the mittens extra payment. There any indication that might expand health care lee It is. Yeah. Well, we'll deal one thing at a time. Yeah. We we haven't, we haven't fine tuned that. My suspicion is it would be health care related. But in terms of how, that's how that's done. We haven't negotiated that yet. It'll be budget related. I agree with that. I agree with that Wilson. Yes, I agree. Or do you have a projection still working um as far as the C. O. N. Provisions, How closely does this resemble what was in the building senate passed last year versus the compromise idea that the hospitals had floated? I think september of last year. Where are we in that sort of, it's hard for me to without actually getting something on paper. I would say that this is probably somewhere between what the hospitals had had suggested and what was in the Senate bill. Um, but there there there's a lot of detail that um, you need to put them right next to each other to compare them. What I can say is I believe that this agreement represents the most significant modification of C. O. N. Law in north Carolina since we began having certificate certificate of need requirements uh, and it is a uh markedly positive step in the right direction. In my my opinion, one other question with sort of looming deadline. I forget exactly what it was for removing uh sort of some of the expansion population from the Medicaid rolls now that the covid state of emergency has ended that put any pressure on to get this deal out the door so that you're not taking these people off the Medicaid rolls and then putting them back on six months later. I think that was part of it. Honestly, I think the the the most pressing issue has to do with the hash payments. Uh and I think that probably had as much to uh to do with the rapidity with which we've been able to reach this agreement as anything. Um I'd have to ask one of our around that to say on that what we've forecasted as a process that can begin on april 1st. The Feds have prohibited any preliminary work from being done for those re evaluations. Uh and we don't expect even projections we've done with the department on how those individuals come off almost 34 of them fall in the last quarter of the year. Uh So I think those that would begin coming off would be a very limited number and the populations are very different. This is a population that's on right now had to have met one of the previous Medicaid qualifications before versus there are now new qualifications under this bill. So there's not a tremendous amount of overlap between those two right on target. Yes, exactly expected. Yes. Use. So here, here's what I would say that this agreement represents uh negotiations between the House and the Senate. The governor was not involved directly in those negotiations. The governor has been clearly involved in being an advocate for expansion. Uh He's also been uh involved in uh talking to hospitals and others uh in in an effort to assist us in getting to an agreement. But the negotiation was a House Senate negotiation and the agreement is a House Senate agreement. I am confident that the governor will be uh pleased with this. Uh My guess is the only thing that he would uh would quibble about is he would want the Medicaid expansion provision to be effective immediately. Uh and we'll have a conversation with him about that as well. And um echo 100% center burgers remarks on that. And when I was speaking with the governor, he's been very clear, he just he he likes the fact of what was passed and he basically encouraging us to see if we can resolve the differences between the two chambers on the on the other issues. I don't think he's weighed in at all. And any of that hasn't, our side hasn't on your side, not in the negotiation. That's true. I mean, for you all and the other lawmakers, what is it the fact that this is actually happening today? I guess this was yesterday that you freeze. What do you what does this mean for, you know, the relationship between the House and the Senate with Mansion and everything else? We'll have to find something else to fight about. Yeah. So you're so you're now shot twice in the same week. Right. That was, that was great. No, no, I think, I think it just signals what really has been, what continues to be a very good working relationship between both myself and senator burger and then all of our members between the two chambers. I mean, we have, uh, but I will tell you this, we've had some, you know, disagreements on policy matters, but they've always been approached with honesty and integrity and candor and, and folks lay out where they are on the issues. And that's why we've been able to get so much done. I mean, it it's, this is a, as you, as you go, as we're going through the details of this. The thing that sort of, that I was thinking about the whole time when central burger was going through is what a huge announcement this is from north Carolina. What a huge policy direction this is that, that's going to provide help for so many in this state. But it's going to do it in a way that is fiscally responsible. I mean, for years and years, you know, we resisted expansion because we saw the, the prospects that the state's cost could easily triple that. It could be a runaway budget When, when we all first came to power. One of the first things that we had to do was to rein in debt to the federal government and to rein in an absolutely broken Medicaid system that continue to have overrun overrun. We had what, nearly $1 billion dollars one year. I mean, it was, it was broken now it stays within budget. Uh, you now have an opportunity now that you've managed that to be able to find a way to responsibly expand that coverage because of these additional funds that are there. And at the end of the day, uh, when you when you put a put a pin to the back of a napkin, it's a it's it's it's a net break, even at worse, a net positive, frankly, if you do the math on it. So, um, it worked out well, last question and the 1.8 billion, I think it's 1.5 billion somewhere in that range is, and then it's a recurring every year, 800 million. I mean, there's there's a staggering numbers. Um, and it and it's uh, it's it's a net positive and as as the federal government is concerned, it is not tied to any particular part of the state budget. That's just additional dollars that come into the state, yep, thank you all for being here, appreciate you. That's right. It's an unusual experience

State lawmakers make major health care policy announcement

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Brian Shrader flies over the site of a plane crash at Raleigh-Durham International Airport approximately three hours after the accident.

Seen some activity just in the past 10 minutes or so. I want to take you outside Sky five right now for a live look at the scene. We saw a van being escorted to the runway there and someone got out and now there appears to be a really careful inspection of the debris going on. So we're working to confirm if that may be the NTSB investigation team arriving at the scene. Let's zoom out and give you some about where this is. There are two main runways at RDU International and this is in the grassy field next to the runway that mostly serves terminal one on the east side of the airport, that runway remains closed while this investigation continues at the top of your screen. That is the other main runway that serves terminal two, mostly that runway is open. So we have two things going on here that could affect your flights for the rest of the day and maybe even into tomorrow, the airport takeoff and landing capacity is roughly reduced by half because they are only working with one runway. And if you have a flight coming out of terminal one, maybe Southwest, you're going to have to take that crossover all the way out to that other runway. It's going to add a lot of extra time.

Sky 5 flies over RDU plane crash 3 hours later 

A UNC Health physician and pilot were taken to the hospital Wednesday after a small plane crashed at Raleigh-Durham International Airport (RDU).


Sky 5 flies over plane crash at RDU

RDU Airport Authority gives an update on a plane crash that sent a physician and pilot to the hospital. The crash occurred Wednesday morning on a flight that took off from Wilmington.

<p>Landguth first, I want to extend my thoughts to those affected by this morning's aircraft accident and thank our first responders for their quick action to respond. The airport authority and its mutual aid partners responded to an aircraft accident at RDU involving a general aviation aircraft. The accident occurred at approximately 10:10 a.m. in the grass next to runway five, right 23 left. The flight was arriving from Wilmington, North Carolina. The A the aircraft is owned by medical Air Inc and operated by UN C air operations. The aircraft had two people on board, one pilot and one passenger. Both were transported to area hospitals. The federal A Bush administration issued a ground stop that was lifted at approximately 1130 this morning. The Federal Aviation Administration and the National Transportation Safety Board have both been notified. The National Transportation Safety Board is en route and expected to arrive within the next hour at which time we will conduct an accident investigation. Rdu's runway five left 23 right reopened to departing and arriving aircraft around 11:30 a.m. this morning. Are you experiencing approximately 70 delays and several arriving flights were diverted to other airports? Until ground stock was lifted, travelers should contact their airline for the latest updates regarding the flight status. And of course questions about the identity and condition of the pilot and passenger should be directed to UN C health. And at this time I'll try to answer any questions. You may have, uh, the one, any other accidents in, in the past. I'm not familiar with any other accidents have occurred with that operation. I don't know, uh, that's the role of the National Transportation Safety Board. They'll actually come in and do the investigation. Uh, and at some point in the future, they write up a report and determine what the cause of the accident was. You know, that there was no notification to the airport authority or to the FAA uh about any type of emergency on board. Do we have a guy? We don't, all we know that we've got them out of the airplane and we've got them transported to local hospitals. We know situations like this and delays have a ripple effect on, you know, flights. Do you have any idea what type of impact we'll see here in our view and for not sure, but what we're going to encourage everybody to do is reach out to your airlines. We'll be able to give you real time information about the impact of your particular flight. Ok. I believe some of them went to Greensboro and I think a couple went to Charlotte as well. What, what to be impacted due to the NTSD. Say that one more time at this point in time, what we call the west side of our airport is now open the investigation they'll conduct will all be on the east side. So at this point, we are anticipating normal operations returning to normal operations from this point forward. I don't think that anything that they're doing regarding the investigation or where they would have to investigate would have any impact to the west side of the airport. No, the aircraft is still on the airfield itself. It's on the east side of the field. So terminal one that runways the east side of the field, that's where the debris field actually sits, the west side of the field is open and operational and safe to operate. Not that I'm aware of in operations for you throughout this event today. What was your main concern concerning the passengers that were in the internals? Right. I think our primary focus when, when that accident occurred were the two people sitting in that aircraft? Our primary mission is to make sure we can get to them and try to rescue them and try to make sure that we can get them in a safe condition as fast as we possibly can. Uh secondarily is trying to figure out then how we recover and get our operations back up and running. Mhm. How does that affect? What goes on term? Yeah, so great. Question. So the team has figured out a way to get all the aircraft they're gonna operate at terminal one. Your Southwest develops. Uh We've got a crossover taxi way that we can actually get them through our general aviation aircraft. We've got a crossover taxiway, we can get them to. But the rest of the uh accident scene is actually kind of isolated and closed and locked off. Yeah, you're terminal one at this point in time. Once they can get back on their schedule, it's going to be a normal operations. All right. Thank you guys. All right. Thank you. Grab your phone, right.</p>

State lawmakers make major health care policy announcement

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