Updates on Tailored Plan criteria review, eligibility criteria, enrollment and health care options, and resources for Beneficiaries and Providers.
Topics Related to Medicaid Managed Care
NC Medicaid is working with Standard Plans to create easier pathways for providers to reach Standard Plans and resolve panel issues.
Provider manual update, guidance on position qualifications, phased assignment approach for Tailored Care Management providers and more.
NC Medicaid is sharing a list of member counts for Advanced Medical Home practices affiliated with Tailored Plans
Evaluates the impact of the North Carolina Medicaid Transformation on primary care and obstetrics/gynecology (Ob/Gyn) practices
Quality metrics that will assess health plans’ performance across their populations
A delay in identifying individuals in NCTracks as dually eligible for Medicare and Medicaid has been discovered.
From Dec. 1, 2022, to June 30, 2023, they will receive an enhanced medical home payment of $20 per member per month.
Key milestones, playbook updates, verifying eligibility, reverification and more
Independent laboratories shall bill services to the hospital for whom they are providing clinical lab services. Hospitals should bill the PHPs.