Topics include: key dates, contracting reminders, provider ombudsman, playbook updates, outreach to patient panels, webinars, provider directory, PHP quick reference guides, Help Center and Tailored Care Management certification.
Topics Related to Medicaid Managed Care
Medicaid beneficiaries currently eligible to transition to managed care have selected or been assigned a health plan.
End-Dating the Use of Taxonomy Code 313M00000X (Nursing Home-Intermediate Level of Care) From Provider Permissions Matrix, Continuation of Temporary Suspension of Level I and Level II Assessments for New Nursing Home Admissions, NCMUST Webpage Update, PASRR Submission and Required Supporting Documentation
NCDHHS is releasing data on the number of beneficiaries, as of April 2021, who currently meet the eligibility criteria to enroll in Tailored Plans and receive Tailored Care Management scheduled to launch in July 2022.
NC Medicaid has published updated guidance on Tailored Care Management, including updates on Advanced Medical Home + (AMH+)/Care Management Agency (CMA) Certification, capacity building and rates.
NCDHHS is in its final week of open enrollment for NC Medicaid Managed Care. Through Friday, May 14, beneficiaries can choose a primary care provider (PCP) and a health plan for their families’ care in preparation for the launch of NC Medicaid Managed Care on July 1.
DHHS has developed a reconsideration process for providers’ use following the validation of the provider submitted attestation information.
New Long-Term Services and Supports Care Management web page, Advanced Medical Home Provider Manual 2.1 released and Program Guide added.
To assist with identifying North Carolina Medicaid and NC Health Choice beneficiaries currently assigned under the Community Care of North Carolina/Carolina ACCESS (CCNC/CA) program, NCDHHS generated a new Advanced Medical Home (AMH) NC Medicaid Direct/NC Medicaid Managed Care Primary Care Provider (PCP) Enrollee Report for distribution to CCNC/CA participating providers.
Key dates for transitioning to NC Medicaid Managed Care, Provider contracting reminders, Provider Playbook updates, Provider outreach to patient panels, webinars, Provider and health plan look-up tool, PHP quick reference guides, help center, Provider Ombudsman and Tailored Care Management certification.