Medicaid Transformation

Medicaid Transformation

More Detail Released on Care Management in the Tailored Plans

June 5, 2019

NC DHHS has published a concept paper putting more detail into the concept of care management for those individuals who qualify for the Behavioral Health/Intellectual-Developmental Disability (BH/IDD) Tailored Plan.  Unlike the Standard Plan, every Medicaid beneficiary who is in a BH/IDD Tailored Plan will be assigned a care manager, with limited exceptions.  The care management…


Senate Budget Analysis

The Senate introduced and passed their budget proposal in the same week, just as the House did earlier this month.  That moves the budget ahead to a conference committee, yet to be appointed, and made up of House and Senate members, where the differences between the two budgets will be reconciled.  When you review the…

Medicaid Transformation

BH/IDD Tailored Plan Eligibility and Enrollment

April 30, 2019

NC DHHS published a “Final Guidance” paper entitled, “BH/IDD Tailored Plan Eligibility and Enrollment”.  Final guidance may reference that NC DHHS will not seek any more feedback on the policy, although it is qualified that NC DHHS has the right to amend the policy in the future.  This paper accompanies the November 2017 concept paper,…

Medicaid Transformation

Medicaid Standard Plan RFP Summary Guide

February 6, 2019

Now that DHHS has announced the Medicaid Managed Care Pre-Paid Health Plan Providers (PHPs) for the Standard Plan, you may be looking for details on what is required of the PHPs and how the Standard Plan will affect Behavioral and I-DD services.  You are in luck, i2i Center staff have distilled down almost 500 pages of RFP…

Medicaid Transformation

Tailored Plan Care Management Becomes Clearer

January 31, 2019

On January 24th NC DHHS held a webinar that provided additional, point-in-time information on the planning for the BH/IDD Tailored Plans. It was explained that these are initial discussions and that there will be further detail as planning progresses. NC DHHS will continue to offer webinars and other learning opportunities as well as concept papers…

Medicaid Transformation

Long Time Behavioral Health IMD Exclusion Provisions are Lifted

November 29, 2018

Included in the North Carolina 1115 Medicaid waiver that was just approved by the federal Centers for Medicare and Medicaid Services (CMS) was a waiver request on the Institution for Mental Diseases (IMD) exclusion that applies to substance use disorder facilities with 16 or more beds. This waiver will allow Medicaid funds to be used…