Medicaid Transformation

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

Healthy Opportunities Pilots to Further Whole Person Care

February 28, 2019

As a part of the Medicaid 1115 waiver application, NC DHHS submitted a “Healthy Opportunities” pilot. The pilot was approved along with the Medicaid 1115 waiver. This pilot brings an exciting prospect for achieving an important aspect of whole person care because it allows for Medicaid/Health Choice reimbursement in four areas of Social Determinants of…

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…

Medicaid Transformation

Medicaid Transformation Gets 1115 Waiver Approval

October 31, 2018

NC DHHS announced on October 24th that the 1115 Medicaid waiver application has been approved by the Centers for Medicare and Medicaid services (CMS). This approval was a major hurdle to overcome and now almost guarantees the timeline that NC DHHS had set for implementation going forward. The approved waiver includes the BH/IDD Tailored Plans…

Medicaid Transformation

Responses Received on RFP for Standard Plan

October 22, 2018

DHHS has posted on their website the names of the organizations that responded to the Standard Plan RFP to be either a statewide plan or a provider-led entity.  They are as follows: Aetna AmeriHealth Caritas North Carolina Healthy Blue – a partnership of Blue Cross and Blue Shield of North Carolina and Amerigroup Partnership Plan…