Protocol for Changing Advanced Medical Home Tier Status

As NC Medicaid’s managed care launch date approaches, Advanced Medical Home (AMH) providers who believe they are not ready to meet program requirements to perform at the tier level to which they attested may now submit a request to change their AMH Tier status from Tier 3 to Tier 2. The AMH Tier 3 providers may not downgrade lower than AMH Tier 2. Because the NCTracks AMH Tier Attestation Tool does not permit providers to lower their own Tier status, providers are required to submit a letter on practice letterhead which contains:

1. A formal request to downgrade to an AMH State-approved Level Tier 2 provider
2. Organization name (DBA, service location name may be included)
3. NPI and service location address of practice
4. Signature of the NCTracks assigned Office Administrator (OA)
   - The request must be initiated and signed by the OA as he/she is the only person with the authority to submit changes to the NCTracks record.
5. Contact information of OA, at minimum:
   - Phone number
   - Email

The Department certified AMH tier level cannot be lower than the PHP contracted tier level.  Requests to lower the AMH tier level below the PHP contracted tier level will be denied. 

The preferred method of submission is via email to Medicaid.StateAMHchangerequest@dhhs.nc.gov. 

All AMH participating providers wanting to attest to a higher level may do so using the NCTracks AMH Attestation Tool. For details about this process, see the full protocol.