March 12, 2020
A memo was released by NC DHHS on March 6th that provides detail about needed capacity for Standard Plans in crisis services. Within the current structure of Medicaid, individuals with behavioral health crises are referred directly to the LME/MCOs. When the shift to have Medicaid beneficiaries with mild to moderate behavioral health needs in the…
NC DHHS recently published a Request for Application (RFA) pre-release concept paper that outlines the proposed requirements for the BH/IDD Tailored Plans. Legislation states that opportunities to be BH/IDD Tailored Plans are only available to the LME/MCOs for the first four years after the implementation of the Standard Plan. Legislation also established that the BH/IDD…
March 1, 2020
Every day, people move from one insurance company to another and from one medical professional to another. NC DHHS has published a draft concept paper that lays out more detail on how Medicaid beneficiaries can move from one payer or provider to another while their continuity of care is maintained during the initial implementation of…
February 4, 2020
The concept paper on State-funded BH/IDD services lays out a plan of action to create a more statewide, standardized approach to State funding. The paper indicates the State’s intent to move to a centralized decision-making process for eligibility, as reflected in the emphasis on the statewide structure described below. In addition to state funded services,…
NEWS UPDATE 2/11/20 Since the publication of the article below on the BH/IDD Tailored Plan Care Management application process NC DHHS has announced an extension before they begin the application process. Originally they were to begin the first round of applications for Advanced Medical Home Plus practices and Care Management Agencies in February 2020. That…
The recently published concept paper, “North Carolina’s VBP Strategy for Standard Plans and Providers in Medicaid Managed Care” provides a lot of detail on strategies NC DHHS will employ to support the expanding use of value-based payment (VBP). While their support strategies are optional, the paper also details the State’s contractual expectations for Prepaid Health…
January 14, 2020
While the implementation of managed care has been suspended as legislative action is needed to move forward, the Department continues to work on the design of Tailored Plans to serve individuals with behavioral health and intellectual disabilities in lieu of Standard Plans. In addition to managing Medicaid services, Behavioral Health I/DD Tailored Plans also will be…
This paper released on January 8th, provides details on an optional Medicaid ACO program, including ACO organizational requirements, payment parameters, total cost of care calculation and participation incentives for early adopters. PHPs and providers can form ACO arrangements as a way to promote value in Medicaid and meet the Department’s VBP targets. The Department welcomes…