Effective July 1, 2023, NC Medicaid received approval from the Centers for Medicare & Medicaid Services (CMS) to offer 1915(i) services to NC Medicaid beneficiaries with qualifying diagnoses who were deemed eligible. 1915(i) services are home and community-based services (HCBS) which provide opportunities for Medicaid beneficiaries to receive services in their own home or community settings instead of institutional settings.
The NC Medicaid 1915(i) services are:
- Community Living and Support,
- Community Transition,
- Individual and Transitional Support,
- Respite,
- Individual Placement and Support, and
- Supported Employment.
This bulletin applies to the Behavioral Health Intellectual/Developmental Disabilities (I/DD) Tailored Plan (Tailored Plan) upon launch.
To receive 1915(i) services, federal regulations require that an assessment be completed to determine eligibility for services. There are some members accessing 1915(b)(3) services who are moving into Tailored Plans and have not yet received the necessary assessment to receive 1915(i) services.
- NC Medicaid worked with plans to identify these members and is providing eligibility for individuals who need to complete an assessment or reassessment for 1915(i) services.
- Members who are impacted will receive letters from NC Medicaid related to their eligibility and it will note that this eligibility only lasts until Aug. 30, 2024, to allow additional time to complete the assessment for 1915(i) services.
It is critical for beneficiaries enrolling in a Tailored Plan to complete a 1915(i) assessment as soon as possible. The Department continues to encourage providers of 1915(i) and 1915(b)(3) services to work with Tailored Care Managers/Care Coordinators to get beneficiaries assessed for 1915(i) services and to update the Care Plan/ISP.
Additional guidance on care plan/ISP completion can be found in the Tailored Care Management (TCM) Provider Manual on the Tailored Care Management webpage under the Provider Resources section.
For more information on the 1915(i) services, see the NC Medicaid Obtains Approval of the 1915(i) State Plan Amendment bulletin. Please also see the North Carolina Transition of 1915(b)(3) Benefits to 1915(i) Fact Sheet for additional information for providers in accessing these services.
Contact
NCTracks Call Center: 800-688-6696