Medicaid State Plan Public Notices
Title XIX of the Social Security Act requires that North Carolina provide a plan to administer and manage the North Carolina Medicaid Program. The North Carolina Medicaid State Plan outlines the organization and function of the Division of Health Benefits. It provides amount, scope and duration of services, as well as eligibility requirements.
Medicaid Expansion Alternative Benefit Plan State Amendment
This alternative plan outlines the benefits available to the Medicaid Expansion eligibility group. North Carolina is proposing to provide all individuals who are eligible for expansion with the same benefits provided to current Medicaid beneficiaries.
Alternative Benefit Plan documents are listed below:
- ABP1 Populations
- ABP2 Voluntary Benefit Package Selection Assurances
- ABP3 Selection of Benchmark Benefit Package
- ABP4 Alternative Benefit Plan Cost-Sharing
- ABP5 Benefits Description
- ABP7 Benefits Assurances
- ABP8 Service Delivery Systems
- ABP10 General Assurances
- ABP11 Payment Methodology
Waivers
1915(b) Mental Health, Intellectual/Developmental Disability (IDD) and Substance Use Disorder (SUD) Waiver Amendment for Tailored Plan Launch
Print application selector for 1915(b) Waiver: NC.0002.R05.02
NC.1326.R01.02 - (b)(c) Concurrent TBI Amendment Approval Letter
NC.0423.R03.10 - (b)(c) Concurrent Innovations Amendment Approval Letter
Application for 1915(c) HCBS Waiver: NC.0423.R03.10
NC.0423.R03.10 - (b)(c) Concurrent Innovations Amendment Approval Letter
1915(C) NC TBI Waiver Amendment for Tailored Plan Launch
Application for 1915(c) HCBS Waiver: NC.1326.R01.02
NC.1326.R01.02 - (b)(c) Concurrent TBI Amendment Approval Letter
Community Alternatives Program for Disabled Adults Renewal Waiver Application Update
Community Alternatives Program for Disabled Adults Approved Waiver
For more information, please visit the CAP/DA webpage.
Community Alternatives Program for Children Waiver Renewal
- 1915(c) HCBS Waiver: NC.4141.R07.01 Final Waiver
- 1915(c) Community Alternatives Program for Children (CAP/C) Waiver - NC.4141.R07.01 Approval Letter
Access Monitoring Review Plan
In 2015, the Centers for Medicare and Medicaid Services (CMS) established regulations (42 CFR § 447.203) for states to document whether Medicaid payments are sufficient to enlist providers to assure beneficiary access to covered services. These regulations require states to develop and submit an access monitoring review plan (AMRP or Plan), every three years, for selected service categories. The Plan must present an access monitoring analysis including data sources, methodologies, baselines and assumptions. 2016-2018 Access Monitoring Review Plan (AMHRP)
Proposed Public Notices for State Plans
- 2023 Proposed Public Notices
- 2022 Proposed Public Notices
- 2021 Proposed Public Notices
- 2020 Proposed Public Notices
- 2019 Proposed Public Notices
- 2018 Proposed Public Notices
- 2017 Proposed Public Notices
- 2016 Proposed Public Notices
- 2015 Proposed Public Notices
- 2014 Proposed Public Notices
- 2013 Proposed Public Notices
2023 Ten-Day Posting for Submission to the Centers for Medicare and Medicaid Services (CMS)
New postings coming soon.
Previous Ten-Day Posting for Submission to the Centers for Medicare and Medicaid Services (CMS)
- 2023 Ten-Day Postings for Submission to CMS
- 2022 Ten-Day Posting for Submission to CMS
- 2021 Ten-Day Posting for Submission to CMS
2023 Proposed Amendments Sent to CMS
- SPA 23-0001 Proposed Amendment (Estate Recovery)
- SPA 23-0002 Proposed Amendment (ED Bed Hold)
- SPA 23-0003 Proposed Amendment (Home Health EVV)
- SPA 23-0004 Proposed Amendment (8B Inpatient Behavioral Health Services)
- SPA 23-0006 Proposed Amendment (Opioid Treatment Program)
- SPA 23-0007 Proposed Amendment (Former Foster Care Coverage)
- SPA 23-0008 & SPA 23-0010 Proposed Amendment (SCHIP to MCHIP)
- SPA 23-0009 Proposed Amendment to CMS (MCHIP Expansion)
- SPA 23-0011 Proposed Amendment to CMS (Home Infusion Therapy -HIT)
- SPA 23-0012 Proposed Amendment to CMS (Eligible Medical Professionals-Physician's Services)
- SPA 23-0013 Proposed Amendment to CMS (Physician's Services)
- SPA 23-0014 10-Day PN Clinically Managed Residential Withdrawal Services
- SPA 23-0015 Proposed Amendment to CMS (Medically Monitored Inpatient Withdrawal Services)
- SPA 23-0016 Proposed Amendment to CMS (Disaster SPA Extension)
- SPA 23-0017 Proposed Amendment to CMS (CHIP Health Service Initiatives)
- 23-0018 Proposed Amendment to CMS (Ambulatory Withdrawal Management without Extended Onsite Monitoring)
- SPA 23-0019 Proposed Amendment to CMS (CMARC & CMHRP)
- 23-0020 Proposed Amendment to CMS (Ambulatory Withdrawal Mgmt with Extended On-Site Monitoring)
- SPA 23-0028 Proposed Amendment to CMS (Medicaid Expansion FMAP)
- SPA 23-0029 Proposed Amendment to CMS (Medicaid Expansion Alternative Benefit Plan (ABP)
- SPA 23-0030 Proposed Amendment to CMS (Medicaid Expansion Eligibility)
Proposed Amendments Sent to CMS
- 2022 Proposed Amendments Sent to CMS
- 2021 Proposed Amendments Sent to CMS
- 2020 Proposed Amendments Sent to CMS
- 2019 Proposed Amendments Sent to CMS
- 2018 Proposed Amendments Sent to CMS
- 2017 Proposed Amendments Sent to CMS
- 2016 Proposed Amendments Sent to CMS
- 2015 Proposed Amendments Sent to CMS
- 2014 Proposed Amendments Sent to CMS
- 2013 Proposed Amendments Sent to CMS
Modified Adjusted Gross Income (MAGI)
2015 State Plan Amendment - MAGI
Updates
- 2022 Updates
- 2021 Updates
- 2020 Updates
- 2019 Updates
- 2018 Updates
- 2017 Updates
- 2016 Updates
- 2015 Updates
- 2014 Updates
Medicaid State Plan
State Plan under Title XIX of the Social Security Act Medical Assistance Program
NC Health Choice State Plan
Child Health Plan under Title XXI of the Social Security Act Children's Health Insurance Program
This page was last modified on 09/29/2023