The North Carolina Department of Health and Human Services awarded Keystone Peer Review Organization, Inc. (Kepro) the contract as the Comprehensive Independent Assessment Entity (CIAE) for the NC Medicaid program. Kepro was selected based on a thorough and fair evaluation of responses submitted to the Request for Proposal (RFP) posted by the Department July 21, 2022.
Once fully implemented, beneficiaries and providers will have a single point of entry for obtaining LTSS programs in NC Medicaid Direct. This single point of entry will be branded as NC Medicaid Linking Individuals & Families for Long Term Services and Supports (LIFTSS).
NC LIFTSS is designed to streamline access to LTSS, reducing wait time between initial contact and service enrollment. NC LIFTSS will:
- Process referrals;
- Perform option counseling;
- Conduct assessments and quality assurance reviews;
- Provide service plan management and customer service; and
- Conduct provider training for the following LTSS programs: State Plan Personal Care Services (PCS), Community Alternatives Program for Children (CAP/C) and Community Alternatives Program for Disabled Adults (CAP/DA).
NC LIFTSS will also provide management and oversight for the Pre-Admission Screening and Resident/Review process (PASRR) Level II and serve as North Carolina’s Transition of Care Coordinator (TCC) for nursing home residents who request information about options for less restrictive care settings.
Over the next few months, NC Medicaid will conduct a phased implementation of NC LIFTSS to simplify access to NC Medicaid Direct LTSS benefits for eligible beneficiaries. Until that time, all programs listed above should continue to interact with their assigned contractor(s) and follow their current referral and assessment protocol.
To ensure Medicaid long term services and supports continue without disruption to providers and beneficiaries, informational webinars are being planned in conjunction with Kepro to provide the details of the transition plan for the programs noted above.