Medicaid Transformation


Tailored Plan RFA Released

November 16, 2020

The North Carolina Department of Health and Human Services (NCDHHS) issued a Request for Applications for Behavioral Health I/DD Tailored Plans as part of North Carolina’s transition to Medicaid Managed Care. Look for i2i Summary of RFA in upcoming News Brief issue. As directed by the North Carolina General Assembly, for the first contract term,…

Medicaid Transformation

Medicaid Transformation Prep Ramping Up

October 7, 2020

Opportunities are being made available to stakeholders to prepare for the implementation of the Medicaid Standard Plan and Tribal Option.  Both plans are scheduled to go-live on July 1, 2021.  NC DHHS has held several feedback sessions with stakeholders to review their planned timeline for preparation.   In addition, a weekly webinar series for providers has…

Medicaid Transformation

Medicaid Managed Care Implementation Update

August 17, 2020

The Joint Legislative Oversight Committee on Medicaid and Health Choice received some revealing updates on Medicaid managed care implementation from NC DHHS leaders Dave Richard, Deputy Secretary for NC Medicaid and Jay Ludlam, Assistant Secretary for Medicaid.  They provided insights into what the Department is working on right now for implementation.  A number of key…

Medicaid Transformation

Medicaid Transformation Ramping Back Up

July 14, 2020

The new law, SL 2020-88, now gives a date certain, July 1, 2021, by which the Standard Plans will begin.  There is a tremendous amount of detail that goes into meeting that implementation date.  Of course, NC DHHS is not starting from scratch, but some of the infrastructure built to meet the previous February 2020…


Senate Moves Medicaid Transformation Bill Along

June 12, 2020

This week, S808, now called Medicaid Funding Act, was substantially changed through a committee substitute that was passed in the Senate Appropriations Committee.  Here is the breakdown of the substitute bill: Related to Medicaid Transformation Changes start date for Standard Plans to no later than July 1, 2021; Authorizes each PHP, including the regional PHP…

Medicaid Transformation

Clarity Offered on Crisis Services across Standard Plans

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…

Medicaid Transformation

RFA Pre-Release Spells Out Requirements for BH/IDD Tailored Plans

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…

Medicaid Transformation

Transition of Care Across Medicaid Plans Detailed in Concept Paper

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…