Key Advocacy & Fundraising Update: Your Contributions at Work

We want to provide a vital update on how your financial contributions are directly fighting for our professions, and extend a massive thank you to everyone who has donated to this cause.

With your donations, NCSHLA hired Cody Underwood, a CPA familiar with healthcare from the Richie May firm, to compose, conduct, and analyze a comprehensive cost-analysis survey. Cody has assured us that we had fantastic participation and have collected excellent, highly robust data.

He is currently using this data to write an official white paper. The findings clearly demonstrate how North Carolina's low reimbursement rates are causing providers to struggle to keep doors open, cover administrative overhead, recruit and retain staff, and continue providing essential patient services. Members who donated to help fund this CPA initiative will receive a personal copy of this white paper, which can be utilized as a powerful tool to help negotiate more favorable rates with private insurance companies.

Where your continued support is going: Any additional advocacy funds will compensate our special project lobbyist, Peyton Maynard (who previously served as NCSHLA's Executive Director and lobbyist). Peyton is helping us negotiate with NC Medicaid regarding the new timed CPT codes that could impact us starting January 2027, once CMS finalizes and posts those rates. We will share more detailed information on these rate advocacy efforts as soon as the proposed rates are released by CMS this summer.

To ensure we can fully cover these ongoing, heavy legal and analytical expenses, we are continuing to solicit funds. If you are able, please consider making a contribution. (Or an ADDITIONAL contribution) You must specify "ADVOCACY DONATION" in the comments when submitting your donation so the funds are properly allocated. Click "Give NOW" under the Partner tab of the NCSHLA website.

NCSHLA Champions SLP Value and Patient Safety at 2026 Legislative Advocacy Day

On Tuesday, June 9th, a dedicated team of Speech-Language Pathologists stepped up to represent NCSHLA at the state legislative building for our annual Legislative Advocacy Day. A massive thank you to Stephanie Molina (and her daughter), Rachel Meinel, Blake Hudson, and Jessica Kinard for volunteering their time, expertise, and passion to ensure our professional voices were heard in the halls of government.

We also extend our deep gratitude to our NCSHLA lobbyist, Ashley Perkinson, for organizing these vital, face-to-face appointments with lawmakers.

Strategy Shift: Pivot to Strategic Value

Our primary, long-standing priority continues to be advocating for fair Medicaid reimbursement. North Carolina SLPs have not seen a Medicaid rate increase in over 20 years and have instead absorbed multiple cuts.

During our meetings, lawmakers clarified that due to intense current budget constraints, direct rate increases are not feasible in the budget cycle expected to pass by the end of July. Hearing this feedback, our advocacy team executed a brilliant creative pivot. Rather than stopping at a budget standstill, we shifted the conversation to educational value and fiscal responsibility.

Meeting with Representative Crawford, Representative Hawkins, and Dr. Tim Reeder, our team highlighted how underutilizing SLPs actually worsens state bottlenecks and increases costs. We focused heavily on two interconnected areas:

1. Easing the Autism Spectrum Disorder (ASD) Diagnosis Bottleneck

Currently, massive waitlists for psychological evaluations leave desperate parents waiting months or years for an ASD diagnosis. This bottleneck frequently drives families to turn to certain ABA clinics offering same-day diagnoses, which may not always be accurate.

Our team educated legislators on a critical reality: Communication is the primary characteristic of autism diagnosis and treatment. By expanding policy to allow SLPs to bill Medicaid directly for these evaluations, the state could dramatically reduce barriers to care—especially in rural areas where an SLP is accessible but a psychologist is not. Jessica Kinard is actively coordinating with Dr. Reeder to provide data on licensure and billing language to see if this barrier can be cleared through DHHS or legislative action.

2. Advocating for Guardrails on Behavioral Therapies

We provided critical education on the intersection of behavior and communication. While children are frequently placed into intensive ABA therapy (often 40+ hours a week) to address behaviors, speech-language pathology principles show that these behaviors are usually a direct result of an inability to communicate.

By prioritizing our board-licensed speech-language pathologists and registered speech-language pathology assistants first to address the root communication piece, challenging behaviors naturally decrease. Shifting the state's focus toward these highly qualified, credentialed professionals protects patients, ensures clinical accuracy, and naturally frees up state budget dollars by reducing reliance on over-extended ABA hours. This foundational, regulated training in communication is a distinct asset that a BCBA or technician simply does not possess.

A Major Win for Providers: After Advocacy Day, our special project lobbyist, Peyton Maynard, shared a major piece of positive information. Representative Donny Lambeth successfully quashed another proposed Medicaid provider rate cut that had been quietly pending for this budget cycle. Thanks to champions like Rep. Lambeth, we will not receive a rate cut in this budget. Peyton is continuing to leverage this momentum to negotiate a favorable Medicaid rate when the updated 92507 timed codes and rates are announced by CMS.

Looking Ahead: Momentum & Relationship Building

The day was filled with "aha" moments for lawmakers, many of whom had never had the evaluation and treatment processes for Autism broken down to them by communication specialists.

We owe a special thank you to Representative Hawkins, who was incredibly key during our final meeting of the day. He is stepping up to actively help lead our upcoming conversation with the Department of Health and Human Services (DHHS). Thanks to his support, alongside other representatives who are organizing to review our DHHS letter, we are ensuring SLP and SLPA voices are centered as the state builds standards for behavioral therapies. There is even early discussion regarding a potential future bill to support these systemic changes.

Our advocates left the legislative building feeling a distinct, confident shift in momentum. The years spent building real relationships with our state representatives are paying off; we are no longer just asking for changes, we are actively helping them navigate complex healthcare solutions.

Let’s keep this momentum rolling! We urge all NCSHLA members to continue brainstorming innovative ways to advocate for fair reimbursement and to champion the broader, essential ways SLPs, Audiologists and assistants serve North Carolina families.

NCSHLA MEMBERS prepared a comment letter to DHHS Medicaid regarding the proposed revisions to the ABA Clinical Coverage Policy 8F

Our lobbyist, Ashley Perkinson, also shared our comments with key legislators in order show our support for helping save state Medicaid dollars. We encouraged policy provisions that keep ABA aligned with similar professional, clinical and ethical requirements that OTs, PTs, and Speech Pathologists must follow (as in DHHS Medicaid Clinical Coverage policy 10-A) and demonstrated how SLPs can help alleviate service barriers to children. 

Read our comment letter here:  NCSHLA Letter 5.29.26v2.docx