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.

Waivers

Community Alternatives Program for Disabled Adults Renewal Waiver Application Update

Community Alternatives Program for Disabled Adults (CAP/DA) Renewal Waiver Application

For more information, please visit the CAP/DA webpage.

Traumatic Brain injury Waiver Application Update

A draft application for § 1915 (c) Home and Community-Based Services (HCBS) Traumatic Brain Injury Waiver is posted for a 30-day public comment period. The public comment period is from January 27-February 26, 2021. The currently approved TBI Waiver waiver with an effective date of May 1, 2018 will continue to operate at the levels that are previously approved. Submit your comment via email to Medicaid.WaiverComment@dhhs.nc.gov.

TBI Waiver and Public Comment

Community Alternatives Program for Children Amended Waiver Application Update

A draft application for § 1915 (c) Home and Community-Based Services (HCBS) Waiver for the Community Alternatives Program for Children (CAP/C) is posted for a 30-day public comment period. The public comment period is from August 23-September 21, 2019. The currently approved CAP/C waiver with an effective date of March 1, 2017 will continue to operate at the levels that are previously approved.

CAP/C 1915(c) Waiver Amended Application

For more information, please visit the CAP/C webpage.

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

Ten-Day Posting for Submission to the Centers for Medicare and Medicaid Services (CMS)

2022 Proposed Amendments Sent to CMS

Proposed Amendments Sent to CMS

Modified Adjusted Gross Income (MAGI)

2015 State Plan Amendment - MAGI

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 07/25/2022