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State Health Plan board votes on benefit restructuring strategies

On Tuesday, the North Carolina State Health Plan Board of Trustees voted unanimously at its meeting to approve the implementation of a three-tier provider network for 2027 that will strengthen the Preferred Provider Program (PPP), which will steer members toward providers at a cost savings for both the member and the State Health Plan (SHP), while delivering a volume of patients to preferred providers.

Theresa Opeka

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Secretary of Revenue, State Budget Director appear before House Oversight Committee

Multiple state agency and department heads appeared before the NC House Oversight Committee Thursday to brief lawmakers on their respective landscapes and efforts to find and eliminate waste, fraud, and abuse within their programs. The hearings come as state lawmakers gear up for biennial budget negotiations. The purpose of the hearings with agency heads is...

CJ Staff
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NCInnovation directors cleared of conflicts of interest, if wealthy enough

At a board meeting last week for NCInnovation, the private nonprofit given $500 million in taxpayers’ funds to help facilitate commercialization of public university research, directors discussed their work to determine if potential for conflicts of interest exists between members of the investment committee and the financial institutions bidding to manage the half-billion-dollar endowment. While...

Jeff Moore
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Blue Cross will not appeal judge’s State Health Plan ruling

Blue Cross and Blue Shield of North Carolina will not appeal a judge’s decision upholding the shift of a State Health Plan administrator contract to Aetna. Blue Cross’ decision to drop its legal complaint means the shift will take place as scheduled on Jan. 1.

CJ Staff
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Judge rules for Aetna, against Blue Cross in State Health Plan dispute

An administrative law judge has upheld the decision to replace Blue Cross and Blue Shield of North Carolina with Aetna as third-party administrator of the State Health Plan for government workers and retirees. Blue Cross had challenged the process used to grant the TPA contract to Aetna.

CJ Staff