State audit: NC Medicaid paid health care providers with suspended, restricted licenses

The state Medicaid program paid millions of dollars to health care providers with suspended, revoked, or restricted licenses, the NC Auditor’s office found.

The audit identified weaknesses in tracking professional boards’ disciplinary actions and in the recertification process required of providers and companies that treat patient who use Medicaid.

“Because the Division allowed all providers who had professional license limitations to remain enrolled, there was an increased risk that providers whose actions posed a threat to patient safety were enrolled in Medicaid,” the audit said.

In its written response, the state Department of Health and Human Services said it had begun to make the recommended improvements. Dr. Mandy Cohen, DHHS secretary, said in the response that the state is trying to get $13.4 million back from unqualified providers.

Medicaid is government health insurance for low-income children and parents, elderly people, and people with disabilities. About 2.2 million people were enrolled in Medicaid or the Health Choice insurance program for children last year, according to a state report on the programs. The two programs cost about $16.8 billion last year, according to the report. The federal government paid $13 billion and the state $3.8 billion, the report said.

State auditors checked 66 providers who took Medicaid money and had been disciplined by their licensing boards. Of the 66, 26 had had their licenses suspended or revoked. Eighteen of the 26 had not been removed from the Medicaid program. Eight had licenses suspected or revoked for substance abuse, two for sexual misconduct/inappropriate behavior with women, and one had a felony conviction related to health care fraud, the audit said.

Thirty-six of the 66 had license limitations. One oral surgeon’s dental license was revoked after the death of a patient following surgery and after the NC Board of Dental Examiners found a “deliberate, dishonest plan or scheme to routinely and systematically defraud the Medicaid program and to enrich himself for his own personal gain,” the audit said.

The oral surgeon kept his medical license and was allowed provide services that required a dental license. The provider billed $1.5 million for 1,460 Medicaid patients from July 2016 through June 30, 2020, the audit said.

DHHS said it did not know when the audit started that it could remove from the Medicaid program providers who had limitations on their licenses. While the audit was ongoing, DHHS asked the federal agency that oversees Medicaid if those providers could be removed, and learned that it was up to the state to determine whether it was comfortable having them in the program.

DHHS said it established a policy for reviewing providers with license limitations in August 2020. The policy describes when providers should be disqualified from taking Medicaid money and when they should be monitored.

Since a committee was established, 52 providers have been reviewed for license limitations. Six providers were cut off from the Medicaid program, a dozen were monitored, and 34 were determined to be low risk, DHHS wrote.

NC nonprofit launches a campaign to remove Confederate statues from courthouse grounds

A North Carolina criminal justice nonprofit announced a campaign to rid the state’s courthouse grounds of Confederate statues.

NC CRED, the North Carolina Commission on Racial & Ethnic Disparities in the Criminal Justice System, said that monuments to white supremacy should not stand outside courthouses.

“Their presence at courthouses undermines our country’s aspirational goal of guaranteeing equal justice under the law, something that cannot be realized as long as people of color have to walk past monuments to white supremacy to enter a courthouse,” James E. Williams, NC CRED chairman, said in a statement.

Confederate monuments in the state have been removed from public places at an increased pace since the deadly white supremacist rally in Charlottesville, Va. in 2017.

Activists tore down some of them –  the statue outside the old Durham courthouse and Silent Sam at UNC-Chapel Hill, for example.

The pace of removals picked up after the death of an unarmed Black man, George Floyd, at the hands of Minneapolis police last year.  WUNC tracked Confederate monument removals last year and found at least 24 had been removed or approved for removal since Floyd’s death on May 25, 2020.

It’s unclear how many Confederate monuments still stand in the state. NC CRED said 41 are on courthouse grounds.

As part of its public campaign, NC CRED plans to sponsor public events on the history of Confederate monuments in the state, help local communities and groups trying to remove them, and compile information on monument fundraising efforts, accounts of their dedication, and dedication speeches.

“For generations now, Black residents have been bitterly welcomed by these symbols that include monuments, murals, portraits, and other racist iconography,” Rev. T. Anthony Spearman, President of the North Carolina NAACP and NC CRED commission member said in a statement.  “Removing the monuments will not erase history. Instead, it will create history as we endeavor to right the wrongs of what they represent. We’re encouraged by the monuments that have been removed thus far, and hopeful that every single one of them will be removed.”

A more contagious coronavirus variant is found in North Carolina. Better masking is recommended.

The more contagious South African variant of the coronavirus that causes COVID-19 has been found in North Carolina.

The state Department of Health and Human Services said Thursday that the variant was found in a sample from an adult in the central part of the state who had not recently traveled.

Five states have reported cases of infection with the South African variant, according to the Centers for Disease Control and Prevention.  North Carolina has also found 21 cases of the UK variant. These variants appear to spread more quickly, the CDC said. Studies suggest that the Pfizer and Moderna vaccines work against them.

Diagram combining two masks into one

“While we anticipated the arrival of the B.1.351 variant in NC, it’s a reminder that the fight against COVID-19 is not over. The emergence of variants that are more infectious means it’s more important than ever to do what we know works to slow the spread — wear a mask, wash your hands, wait 6 feet apart, and get vaccinated when it’s your turn,” Dr. Mandy Cohen, state Department of Health and Human Services secretary, said in a statement.

With more easily-transmitted variants discovered in the U.S., public health officials are urge people up their mask-wearing practices.

The CDC released a study this week on better-fitting masks and double masks offering better protection from aerosols. Wearing a cloth mask over a medical procedure mask or a tight-fitting medical procedure mask reduced exposure to aerosols by about 95%, the study said.

Using masks with nose wires, wearing a cloth mask over a medical procedure mask, or using a multi-layered cloth mask are among the suggested strategies.

As of Friday, North Carolina had recorded 814,594 COVID-19 cases since the pandemic started. DHHS reports that North Carolina providers have administered nearly 1.5 million doses of COVID-19 vaccines.


Poll: North Carolinians are increasingly willing to take a COVID-19 vaccine

North Carolinians’ willingness to take a COVID-19 vaccine as grown over the last few months, though people are worried about side effects, according to an Elon University Poll released this week.

Forty-five percent of participants in a survey conducted in late January said they would get a COVID-19 vaccine when they could – an increase from 40.5% in December – and 12% said they had already been vaccinated.

The vaccine roll-out has been rocky in North Carolina and nationally. There’s not enough vaccine for everyone who wants it, and appointments to get shots can be hard to arrange. Forty-three percent of the poll’s respondents disapproved of the way the federal government has handled vaccine distribution.

The poll of 1,455 state residents was conducted Jan. 29-31.

A majority – 63% – said they were very worried or somewhat worried about vaccine side effects.

Twenty percent said they won’t take a COVID-19 vaccine, a finding largely unchanged from December.

Of those who have not already been vaccinated, 58% of college graduates said they would get shots when they can, while 39% of people without college degrees said the same.

There’s an age gap: people who are 65 and older are more certain they want to be vaccinated than younger people.

There’s a partisan gap: 52% of Democrats said they would be vaccinated when they are able, while 40% of Republicans and 40% who claim no party affiliation said the same.

There’s an 11-point racial gap: 47% of white residents said they would get shots, while 36% of Black residents said they would.

Fifty-two percent of men said they plan to take a COVID-19 vaccine, while 37% of women said they would.

The state is in phase two of its vaccine roll-out. Vaccines the state allocates are available to health care workers and people 65 and older.

Gov. Roy Cooper announced Wednesday that teachers, other school personnel, and childcare workers will be eligible for COVID-19 vaccines starting Feb. 24. Other frontline workers who are in group 3 can start getting vaccinated on March 10, he said.

Cooper’s office said in a news release that more than 40% of state residents 65 and older have been vaccinated.

NC releases information that shows county-level racial disparities in COVID-19 vaccinations

Details on who is getting COVID-19 vaccines shows that some North Carolina counties have a long way to go to getting shots to Black and Latino residents.

The state Department of Health and Human Services on Friday released demographic data by county.

In Wake, Durham, Orange, and Johnston counties, white residents are getting a disproportionate share

Photo: Fiona Goodall/Getty Images

of vaccines, as they are statewide.

Eligibility may account for some of the disparities. North Carolina is offering COVID-19 vaccine to health care workers and people 65 and older.

Black residents are 21.5% of the state’s population but make up 17% of those 65 and older. Latino residents are a little less than 10 % of the population but make up 2.2% of residents 65 and older.

Still, Dr. Mandy Cohen, head of the state Department of Health and Human Services, said the state “has some work to do” in achieving equity.

“You can look at our data right now on our dashboard, we are not seeing that we are vaccinating our African American community, our Hispanic community, our Native American community at the same rate that we are vaccinating our white community,” she said during a “fireside chat” this week with The Rev. William Barber II, president of Repairs of the Breach.

DHHS said it plans to use fireside chats streamed on social media as a way to get out information about vaccines.

In Wake County, 64.6% of residents are white, according to Census data, while 76% of those who received first doses of COVID-19 vaccine are white.

Nearly 21% of Wake’s residents are Black, according to Census data, while 12% of those who have gotten shots are Black.  More than 10% of Wake’s residents are Hispanic/Latino of any race, but only 3% of those vaccinated are Latino. Asian residents make up about 7.5% of the county’s population and represent 6% of vaccine recipients.

In Durham, 53.4% of residents are white, while 69% of those vaccinated are white; 35.6% of residents are Black, while 21% of those vaccinated are Black; 4.4% of residents are Asian, while 6% of those who have gotten shots are Asian, and 13.7% of residents are Latino, while 4% of residents vaccinated are Latino.

In Orange County, 77.2% of residents are white, while 82% of those vaccinated are white; 11.4% of residents are Black, while 7% of those who have gotten shots are Black; 8.1% of residents are Asian and 7% of county residents vaccinated are Asian, and 8.6% of the county’s residents are Latino, while 4% of those vaccinated are Latino.

In Johnston County, 75.5% of the population is white, while 83% of those who have been vaccinated are white. Twelve percent of those vaccinated in Johnston are Black, while Black residents make up 16.7% of the population. While Latinos are 14.1% of the county’s population, they are 3% of those who have been vaccinated.

The DHHS data does not include demographics on vaccinations of long-term care facility residents and employees, work being done through a federal program.

Cohen told the House Committee on Health this week that the department is addressing equity in a few ways. For example, it is directing a small portion of its vaccine allocation to organizations that hold special events targeted to underserved communities, she said.

“I think we’re on the right path,” Cohen told the committee. “We have a lot of work ahead of us.”