Topics Related to Medicaid Managed Care
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.
NC Medicaid will offer time-limited payments to practices that have attested as an Advanced Medical Home Tier 3 if they can demonstrate successful readiness for AMH Tier 3 responsibilities.
The Department is releasing the draft Tailored Care Management Desk Review Guide and Scoring Tool to support providers applying for AMH+ or Care Management Agency certification.
Providing the most accurate and complete provider information is a top priority so Medicaid and NC Health Choice beneficiaries can make the most informed choice for their health plan and primary care provider.