Author: GDIT, (800) 688-6696
On Nov. 19, 2019, North Carolina suspended the implementation of Medicaid Managed Care. Managed Care policy papers, fact sheets and other documents and information include content that was effective when published and may not reflect changes in timing, schedules and other details due to the suspension. Please direct questions about Managed Care to the Medicaid Contact Center at 888-245-0179.
The Department of Health and Human Services (DHHS) will extend open enrollment for Medicaid beneficiaries and move to a statewide transition to managed care on Feb. 1, 2020.
Managed care was scheduled to roll out in two phases, with part of the state beginning managed care services on Nov. 1, 2019, and most of the state beginning on Feb. 1, 2020. Managed care will now go-live in one phase for the whole state beginning on Feb. 1, 2020.
The timeline has been adjusted because DHHS cannot implement critical actions to go-live with managed care under the current continuing resolution budget. The updated timeline only impacts counties that were in Phase 1; it does not impact counties that were scheduled for Phase 2. The date of Feb. 1, 2020, for statewide implementation remains unchanged.
The 27 counties where open enrollment will be extended include: Alamance, Alleghany, Ashe, Caswell, Chatham, Durham, Davidson, Davie, Forsyth, Franklin, Granville, Guilford, Johnston, Nash, Orange, Person, Randolph, Rockingham, Stokes, Surry, Vance, Wake, Warren, Watauga, Wilkes, Wilson and Yadkin counties.
DHHS will continue to move forward on activities that are not tied to budget action, including supporting open enrollment. Providers are urged to do the same and use this time to finalize contracts with the managed care companies (PHPs).
Well-informed providers are essential to the success of managed care. As one way to support providers, DHHS has created an online Provider Playbook that includes:
- Beneficiary materials
- Readiness resources
- Calendar of upcoming training courses
- Information on meet and greet sessions
- Virtual office hours
- Frequently asked questions
As open enrollment continues, providers are asked to please keep sharing with DHHS what is working and what is not. Begin by contacting NCTracks at 800-688-6696. Staff can escalate issues to an internal SWAT team focused on problem identification and resolution. When needed, issues can be escalated to our SWAT team by calling (919) 527-7460 or emailing MedicaidSWAT@dhhs.nc.gov.
DHHS will host a webcast on Wednesday, Sept. 4, 2019 from 4 – 5 p.m. to provide additional details; the webcast will include time for addressing participant questions. Register online.