Medicaid Transformation

Medicaid Open Enrollment Wraps Up for Standard Plan – What Now?

May 18, 2021

Open enrollment for a Medicaid Managed Care began March 15 and ended May 14th, giving Medicaid recipients two months to choose the Pre-Paid Health Plan (PHP) they want as their insurance program under new Medicaid Standard Plan that will begin on July 1.  For those who did not proactively choose a Standard Plan, NC DHHS…


North Carolina Olmstead Plan and TCLI, Strengthening a Community-Based System

Looking at the North Carolina health and human services public system from the 50,000-foot level will show that there is tremendous movement toward innovation and strengthening of the community-based service system.  Medicaid Transformation has been at the forefront of catalysts for shifts in the public system, but that is not the only initiative that is…

Medicaid Transformation

Medicaid Managed Care Enrollment Information

April 30, 2021

NC DHHS has just released some helpful information for individuals receiving Medicaid that will be affected by the transition to managed care July 1 to help them understand whether or not they need to choose a new Health Plan right now – Do I need to Choose a Health Plan Fact Sheet The Fact Sheet…

Medicaid Transformation

Medicaid Transformation Begins as Open Enrollment Goes Live

March 23, 2021

Moving to Medicaid managed care has been a roller coaster ride in North Carolina.  There have been budget impasses, postponements and lawsuits.  All of those challenges seem to have been overcome.  The money has been appropriated to get started.  Standard Plan members are currently in an open enrollment period to choose their Prepaid Health Plans…

Medicaid Transformation

BH/IDD Tailored Plan Care Management a Work in Progress

The care management function under the BH/IDD Tailored Plan (Tailored Plan) appears to be evolving.  The care management function under the Standard Plan and BH/IDD Tailored Plan have significant differences in requirements based on the needs of the members of these plans.  An initial difference is that an Advanced Medical Home under the Standard Plan…

Medicaid Transformation

Transition of Care Further Explained

If you are a consumer or family member, perhaps the most important aspect of this transformation is assurances that moves between plans, providers and emergency services will not be disruptive.  The Transition of Care policy that NC DHHS has published covers the responsibilities of the Prepaid Health Plans (PHPs) in these circumstances: when a Medicaid…


NC General Assembly Allocates New COVID-19 Funding

Two bills have been signed into law that allocate federal COVID-19 funding and appropriate additional funding to address the pandemic in communities.  The most recent bill, SL 2021-3:  2021 COVID-19 Response and Relief was signed into law by the Governor on March 11th.  Some of the provisions include: For the Community Mental Health Block Grant:…

Medicaid Transformation

Foster Care Specialty Plan Postponed

Based on feedback already received, NC DHHS has postponed the Foster Care Specialty Plan (FC Plan) implementation from July 1, 2022 until July 1, 2023.  The Department will establish a Foster Care Plan Workgroup that will support the development of an interim and long-term plan for children in foster care.  Interested individuals/groups should notify the…