Topics Related to Medicaid Managed Care
The Department released the Advanced Medical Home Provider Manual 2.0 today. This version reflects program expectations as well as recent program modifications and changes that impact provider contracts.
NC Medicaid has released the NC Department of Health and Human Services Transition of Care Policy, which outlines NC Medicaid's vision on the process of assisting a beneficiary through the transition between health plans or between service/payment delivery systems.
To continue supporting providers interested in obtaining certification as an Advanced Medical Home Plus (AMH+) practice or Care Management Agency (CMA), the Round 1 application deadline is being extended from March 1, 2021 to June 1, 2021.
The latest information providers need to know about the transition to Medicaid Managed Care. Update includes the Provider Directory and Health Plan Look-Up Tool, contracting reminders, Provider Playbook updates, upcoming webinars and more.
Additional criteria has been added to identify beneficiaries as eligible for Behavioral Health I/DD Tailored Plans.
Effective April 1, 2021, as part of the transition to Medicaid Managed Care, NC Medicaid will offer time-limited payment to practices that have attested into Advanced Medical Home Tier 3 if they can demonstrate successful readiness for AMH Tier 3 responsibilities.
The public version of the Medicaid and NC Health Choice Provider and Health Plan Lookup Tool is now available. Providers are encouraged to use this tool to confirm the availability and accuracy of information contained in their NCTracks provider enrollment record.
As Medicaid and NC Health Choice transition to managed care, beneficiaries will be notified to select a Prepaid Health Plan as well as a Primary Care Provider/Advanced Medical Home. Beneficiaries who do not self-select will be auto assigned by the Department.
The Tailored Care Management certification process is now open, and providers may submit applications.
Key dates for transitioning to Medicaid Managed Care, contracting reminders, webinar series for providers and practice leaders, review your provider records in NCTracks, the Provider Ombudsman, PHP manuals updated and the beneficiary portal.