The North Carolina Regulatory Reform Act became law (N.C.S.L. § 2023-137) in early October 2023. This law contains updates pertaining to the N.C. Health Information Exchange Authority (NC HIEA). The new law has expanded the list of providers who are no longer required to connect to NC HealthConnex to include chiropractors.

The HIE Act (N.C.G.S. § 90-414.4) requires that providers who receive state funds, such as Medicaid and the State Health Plan, for the provision of health care services must initiate a connection to send data to NC HealthConnex. Previously, certain provider types were exempted from the mandatory requirement to connect and send data by N.C.S.L. § 2019-23.

The following is an expanded list of provider types that have the option to connect on a voluntary basis:

  1. Community-based long-term services and supports providers, including personal care services, private duty nursing, home health and hospice care providers.
  2. Intellectual and developmental disability services and supports providers, such as day supports and supported living providers.
  3. Community Alternatives Program (CAP) waiver services (including Community Alternatives Program for Disabled Adults (CAP/DA), Community Alternatives Program for Children (CAP/C) and Innovations waiver) providers.
  4. Eye and vision services providers.
  5. Speech, language and hearing services providers.
  6. Occupational and physical therapy providers.
  7. Durable medical equipment providers.
  8. Nonemergency medical transportation service providers.
  9. Ambulance (emergency medical transportation service) providers.
  10. Local education agencies and school-based health providers.
  11. Chiropractors licensed under Article 8 of this Chapter.

Providers no longer required to connect but have already submitted a Full Participation Agreement: 

  • Have the option to continue as an NC HealthConnex participant. The provider may choose to still submit data to NC HealthConnex or may simply receive access to the clinical portal and other value‐added services.
    • Access to the clinical portal will allow the provider to view a more complete health record for patients the provider has a treatment relationship with.
    • No action is necessary at this time for providers who plan to remain a full participant of NC HealthConnex.
    • Anyone with a Full Participation Agreement has access to the NC HealthConnex Suite of Services, regardless of their organization’s connection status.
  • Providers who do not want to submit data to NC HealthConnex or access patient data may terminate their agreement. If the agreement has not been signed by the NC HIEA yet, the provider can request that the agreement not be finalized. Providers should send an email to [email protected] if they you do not want the NC HIEA to process their participation agreement or if they would like to terminate it. This will end the provider’s relationship with the NC HIEA and NC HealthConnex.

Providers no longer required to connect but submitted a Submission Only Agreement: 

  • The NC HIEA will reach out to the provider about terminating or replacing their agreement soon.
  • If the organization would like to voluntarily participate in NC HealthConnex in order to view patient records or utilize the NC HealthConnex value‐added features, the organization can complete a Full Participation Agreement, which is available at

For more information about the benefits of participating in NC HealthConnex visit the HIEA website or sign up for the next How to Connect Call that is hosted the last Monday of each month at noon.

Providers with questions may contact the NC HIEA at 919-754-6912 or [email protected] or see the FAQ section regarding connection exemptions for chiropractors.

For question, contact NC HIEA, 919-754-6912