The Department of Health and Human Services and NC Medicaid are committed to working with beneficiaries, caregivers, providers, associations and other stakeholders to improve health care in North Carolina. Below is information for committees and work groups engaged in this collaborative process. Click on a group title for more information.
The Dual Eligibles Advisory Committee, established according to Session Law 2015-245, provides advice to the Department of Health and Human Services as it developes a long-term strategy to cover dual eligibles under Medicaid reform.
HIV Case Management is a client-focused strategy that provides cost-effective, medically necessary services to enhance beneficiary health status and level of functioning.
Federal law requires that states have a Medical Care Advisory Committee (MCAC) to advise them about health and medical care services that may be covered by their local Medicaid programs. In North Carolina, MCAC advises the state about such issues as revisions to existing policies, policy development, and methods of assessing the quality of care, for both Medicaid and NC Health Choice.
Money Follows the Person (MFP) is a state project that helps Medicaid-eligible North Carolinians who live in inpatient facilities moveinto their own homes and communities with support. If you are interested in receiving MFP updates and meeting notices, please email us at firstname.lastname@example.org.
The NC Medicaid Drug Utilization Review (DUR) program for outpatient drugs ensures Medicaid recipients receive appropriate, medically necessary prescriptions that are unlikely to result in adverse medical events.
The Personal Care Services (PCS) Stakeholder Group provides citizens interested in the development and implementation of Personal Care Services with the opportunity to collaborate and share recommendations. The N.C. Department of Health and Human Services meets bi-monthly with community stakeholders to share project status, gather input and identify next steps.
The Medicaid and Health Choice Preferred Drug List (PDL) Review Panel was established by DHHS to conduct open meetings to discuss recommended policies and procedures related to the PDL and to address the public comments that were received during the PDL comment period. The administration and review of the North Carolina Medicaid and Health Choice PDL follows the Preferred Drug List Review Panel Guidelines and Procedures.
Private Duty Nursing (PDN) is substantial, complex, and continuous skilled nursing care provided in the home for medically fragile Medicaid beneficiaries. This service is considered supplemental to the care provided by a beneficiary’s family or designated caregivers, and allows the beneficiary to remain in their residence rather than an institution. Prior approval (PA) is required for PDN services, and is granted based on the beneficiary’s medical necessity and fragility.