Medicaid Managed Care Implementation Update

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 start dates were shared:

• Open enrollment will begin again in March 15, 2021 and will end on May 13, 2021.
• Auto enrollment will begin on May 14, 2021.
• Go live for both the Standard Plan and Tribal Option will be on July 1, 2021.
• Go live for BH/IDD Tailored Plan will be in July 2022.
• Request for Application for BH/IDD Tailored Plans (only LME/MCOs can respond) will be let this fall 2020.  The tentative expectation is that the RFA will be out this November and responses will be due in January 2021. 

To that end, there are multiple tasks that NC DHHS is ramping up again that include:

• Update all stakeholder materials, websites, smart phone apps and technical systems across multiple platforms (Enrollment Broker, health plans, NCTRACKS);
• Update the Consolidated Provider Directory (NC DHHS, Enrollment Broker, health plans);
• Re-review and re-validate Enrollment Broker readiness including call center staff and scripting once rehired;
• Analyze health plan network adequacy to ensure adequate provider networks and processes;
• Moving forward with the Medicaid Managed Care Ombudsmen contract. 

Richard noted the difficulty in ramping up for Medicaid managed care at the same time that the NC DHHS continues its efforts to support the State through the pandemic.  Two points were made about this challenge:  1) uncertainty about provider’s prioritizing contracting; 2) complexity in project planning with rapid evolving conditions (e.g., staff illness, remote working).  In individual conversations with Department staff, there has been some indication that they will be reviewing information that has already been published to make any necessary amendments that address the current environment. 

The Joint Legislative Oversight Committees have geared up while the NC General Assembly is recessed.  The House Select Committee on COVID-19 is also meeting.  The NC General Assembly will return on September 2^nd to address further COVID-19 issues and nominations for legislative committees.  They are not expected to be in session for an extended period of time.