(Raleigh, N.C.) – State Treasurer Dale R. Folwell, CPA, and the State Health Plan (SHP) have been fighting a long battle to lower health care costs for teachers, legislators, retirees, public safety workers and others who serve the people of North Carolina. The SHP Board of Trustees has frozen health care premiums for the past four years and initiated an innovative effort to further lower costs by creating a network of health care providers committed to lower costs through the Clear Pricing Project.
However, the SHP still cannot use its own data to negotiate rates, fees and charges without permission from its Third-Party Administrator – currently Blue Cross and Blue Shield of North Carolina (BCBSNC).
H169 seeks to level the playing field for the $3.5 billion State Health Plan. The bill has bipartisan support with Reps. Ed Goodwin (R), Larry Potts (R), Terence Everitt (D), and Allison Dahle (D) as primary sponsors. The bill would refine 2016 legislation passed during the previous administration.
The 2016 change, S.L. 2016-104, added language into the statutes that gives an unfair advantage to BCBSNC in contract negotiations with the state. HB 169 levels that playing field by removing language that prevents the SHP from using its own data to negotiate rates, fees and charges without permission from BCBSNC.
“We are the customer,” said Treasurer Folwell. “It’s our data and we should be able to use it to negotiate lower health care costs for not only teachers, public safety workers, state and local employees, but legislators as well. Right now, we can’t even be certain that we’re getting the full benefit of negotiated prices from Blue Cross. They won’t allow us or our auditor unrestricted access to their contracts to validate all of our claims’ payments. In most cases, we have no idea if we’re overpaying or not.”
In fact, State Auditor Beth Wood expressed the same concern in her 2011 audit of the SHP. In that audit she found, in part, that, “[t]he Plan is at risk for overpaying medical claims [emphasis added] because the Plan’s auditors do not have access to BCBSNC contracts and cannot independently verify that the Plan receives the proper contractual discounts from BCBSNC’s provider network.”
H169 will be heard at 11 a.m. Wednesday, March 24, in the House State Government Committee.
“I’m very pleased with the overwhelming support we’ve received from both the House and Senate,” said Treasurer Folwell. “I think during these times when we seem to be so divided, this is one thing that we can all support – including Blue Cross. As former Gov. Jim Martin said, ‘doing right, is never wrong’ and this legislation is doing the right thing for not only members of the State Health Plan, but taxpayers like them.”
The SHP, a division of the N.C. Department of State Treasurer, provides health care coverage to nearly 750,000 teachers, current and former lawmakers, state university and community college personnel, active and retired state employees, and their dependents. For more information, visit the SHP website.