September 19, 2018
The Request for Proposal (RFP) for the Standard Plan now includes: Answers to questions submitted by responding organizations; Revisions to the RFP, most notably: PHPs must achieve NCQA LTSS Distinction by the end of Contract Year 3; The Scope of Services medical benefits is inclusive of LTSS services, including Nursing Facility Services, Home Health Services,…
Read moreThe Ombudsman Program is a key component of Medicaid Transformation. NC DHHS released a Request for Information (RFI) for organizations interested in providing the Ombudsman function. Feedback was due on June 27, 2018 and it was a required response for any organization that intends to apply for the contract. Download PDF: Building the Ombudsman Program
Read moreNC DHHS has provided multiple resources on their Medicaid Transformation website that give more detail to the Advanced Medical Home (AMH). The Advanced Medical Home role is primary to achieving an integrated care approach under Medicaid Transformation because the AMH will conduct care management functions. Download PDF: Advanced Medical Home Resources Available
Read moreNC DHHS has published a Request for Proposal (RFP) for organizations interested in being the Provider Data Contractor for the State as it relates to credentialing of providers. Any organization that responds to the RFP should be certified as a Credentialing Verification Organization (CVO) through the national accreditation program that NC DHHS has chosen for…
Read moreShifting from a MMIS to a MIMS will Upgrade State’s Managed Care Capacity In 2013 NC DHHS went live with NC TRACKS. NC TRACKS is a multi-payer Medicaid Management Information System (MMIS) that merged separate information systems for Medicaid, Health Choice, and other programs such as State MH/IDD/SUD funding (known as IPRS, Integrated Payment and…
Read moreAugust 15, 2018
The i2i Center for Integrative Health is launching a new initiative to promote community inclusion for people with mental illness. The initiative is called I’m IN: Community Inclusion.This is a joint project of i2i Center for IntegrativeHealth, Alliance Behavioral Healthcare, and the NC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services. The goal…
Read moreA central focus of the i2i Center is to convene collaboratives on pressing statewide issues. As earlier reported, i2i Center has begun a collaborative on Value-Based Payment and Contracting. North Carolina has a six year history of managed care in behavioral health and intellectual-developmental disability, yet only about 3% of the contracts between LME/MCOs and…
Read moreBy all accounts, there is a lot going on in preparation for moving Medicaid physical healthcare to a managed care model. The General Assembly passed State Law 2018-48, which provided additional direction to NC DHHS on Medicaid Transformation and specifically allowed for the Standard Plan to include the mild-to-moderate behavioral health Medicaid population. NC DHHS…
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