Because of the volume of information available about the North Carolina Medicaid Transformation, our focus is to offer you distilled information that highlights the components of transformation that impact behavioral health and intellectual-developmental disability services.
September 19, 2018
Kody Kinsley has begun a new position as the Deputy Secretary for Behavioral Health and Intellectual and Developmental Disabilities. Mr. Kinsley started with NC DHHS as the Deputy Director of the Division of MH/IDD/SUD Services and served as the Interim Senior Director of the Division. Now, he oversees the Division of MH/IDD/SUD Services, the Division…
The Request for Proposal (RFP) for the Standard Plan now includes: Answers to questions submitted by responding organizations; Revisions to the RFP, most notably: PHPs must achieve NCQA LTSS Distinction by the end of Contract Year 3; The Scope of Services medical benefits is inclusive of LTSS services, including Nursing Facility Services, Home Health Services,…
The Ombudsman Program is a key component of Medicaid Transformation. NC DHHS released a Request for Information (RFI) for organizations interested in providing the Ombudsman function. Feedback was due on June 27, 2018 and it was a required response for any organization that intends to apply for the contract. Download PDF: Building the Ombudsman Program
NC DHHS has provided multiple resources on their Medicaid Transformation website that give more detail to the Advanced Medical Home (AMH). The Advanced Medical Home role is primary to achieving an integrated care approach under Medicaid Transformation because the AMH will conduct care management functions. Download PDF: Advanced Medical Home Resources Available
NC DHHS has published a Request for Proposal (RFP) for organizations interested in being the Provider Data Contractor for the State as it relates to credentialing of providers. Any organization that responds to the RFP should be certified as a Credentialing Verification Organization (CVO) through the national accreditation program that NC DHHS has chosen for…
Shifting from a MMIS to a MIMS will Upgrade State’s Managed Care Capacity In 2013 NC DHHS went live with NC TRACKS. NC TRACKS is a multi-payer Medicaid Management Information System (MMIS) that merged separate information systems for Medicaid, Health Choice, and other programs such as State MH/IDD/SUD funding (known as IPRS, Integrated Payment and…
September 6, 2018
i2i Center staff have distilled down almost 500 pages of RFP jargon and text into the key topics areas. This is an easy to understand Medicaid Standard Plan RFP Guide for those interested in the NC Medicaid Transformation of behavioral and physical healthcare. Sections Include: Guide to the Request for Proposal (RFP) for the Medicaid Standard Plan Timeframes for Implementation PHP…
August 15, 2018
By all accounts, there is a lot going on in preparation for moving Medicaid physical healthcare to a managed care model. The General Assembly passed State Law 2018-48, which provided additional direction to NC DHHS on Medicaid Transformation and specifically allowed for the Standard Plan to include the mild-to-moderate behavioral health Medicaid population. NC DHHS…