Advanced Medical Home Tier 3 Glidepath Payment Reconsideration Process and Attestation Program Update

Attestation Process Overview

The deadline to attest for the June payment is May 14, 2021. If providers have successfully attested in a previous cycle they do not need to attest again. 

Once an Advanced Medical Home (AMH) Tier 3 practice has attested to meeting Glidepath payment eligibility in NCTracks, DHHS will validate that the practice is enrolled with NC Medicaid and attested as an AMH Tier 3 practice. DHHS then confirms the attestation with the respective pre-paid health plans (PHPs) in order to validate that each Tier 3 practice has met contracting and testing criteria. Further information regarding the Glidepath program, including eligibility requirements, can be found on the Advanced Medical Home webpage. 

Reconsideration Process

As detailed in the April 21, 2021 Glidepath Attestation Update bulletin, DHHS has developed a reconsideration process for providers’ use following the validation of the provider submitted attestation information.

Providers have the option of requesting an AMH Glidepath Payment reconsideration under the following circumstances:  

• They missed the attestation deadline due to hardships related to the COVID-19 Pandemic, or
• They disagree with the with the outcome of the validation determination.

If a provider believes they have been denied Glidepath payments in error the following should occur in this order:  

• Contact the health plans that match their attestation to discuss completion of both contracting and testing requirements by the attestation deadlines. 
• If the health plan agrees that the provider met the criteria, the provider should submit this in a statement of agreement with substantiating documentation to Medicaid.Transformation@dhhs.nc.gov, with the subject line of “AMH Glidepath Payment Reconsideration.” 
• NC Medicaid will review this statement and validate that criteria are met for at least two plans by the stated deadline for payment. If it falls after that deadline, consideration can be made for the subsequent payment cycle. 
• If the PHP cannot confirm completion of contracting and testing and the provider organization disputes this, the provider can submit documentation with supporting evidence to substantiate the practice’s position in a statement to Medicaid.Transformation@dhhs.nc.gov, with the subject line of “AMH Glidepath Payment Reconsideration.” 
• Reconsideration requests must be received in accordance with the following timeframes to ensure review, disposition and inclusion by the final glidepath payment distribution in the June payment cycle. 
  • May 14, 2021 (for the April 25, 2021 attestation/May payment and the March 30, 2021 attestation/April payment) 
  • May 23, 2021 (for the May 14, 2021attestation/June payment and a final opportunity for reconsideration of other attestations for payments within the glidepath time period) 

The review committee evaluates reconsideration requests on a bi-weekly basis to ensure a timely review and notification.  

Contact

NCTracks Call Center, 800-688-6696