On November 19, 2019, North Carolina Department of Health and Human Services (NCDHHS) issued a press release detailing the suspension of the Medicaid Managed Care Transformation due to funding issues. In short, this means that the initial phase-out of the fee-for-service model will not go into effect on February 2020 as we were all initially preparing for.
According to NCDHHS, “NC Medicaid will continue to operate under the current fee-for-service model administered by the department. Nothing will change for Medicaid beneficiaries; they will get health services as they do today. Behavioral health services will continue to be provided by Local Management Entities/Managed Care Organizations. All health providers enrolled in Medicaid are still part of the program and will continue to bill the state through NCTracks. “
So as it stands, there is still some uncertainty into what the future may hold for this NC Medicaid Transformation. We will continue to monitor the status of this situation and update our post as more information is released.
Find the NCDHHS press release here: https://www.ncdhhs.gov/news/press-releases/legislators-adjourn-without-taking-actions-required-medicaid-managed-care-dhhs
Beginning in June 2019, North Carolina will go through a Medicaid ‘Transformation’ or in its formal name, Medicaid Managed Care. Within this transition, the normal fee-for-service model will change to a managed care model. According to NCDHHS, this new plan will:
- Deliver whole-person care through coordinated physical health, behavioral health, intellectual/developmental disability and pharmacy products and care models
- Address the full set of factors that impact health, uniting communities and health care systems
- Perform localized care management at the site of care, in the home or community
- Maintain broad provider participation by mitigating provider administrative burden
The transformation process will have multiple phases and will roll-out for different regions at different times. See the timeline and map below to view your region and roll-out phase.
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