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
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
1915(C) NC Innovations Waiver Amendment for Tailored Plan Launch
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.
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.
Community Alternatives Program for Children Waiver Renewal
Proposed CAP/C Waiver renewal posted for public comment on Aug. 12, 2022.
This announces the 30-day public comment period to review the proposed Community Alternatives Program for Children (CAP/C) § 1915 Home- and Community-based Services (HCBS) waiver application. NC Medicaid announced the renewal of the CAP/C waiver in September 2020.
An agreement between the State waiver administrating agency (NC Medicaid) and the Centers for Medicare and Medicaid Services (CMS) must be reached to implement the proposed changes statewide. If substantial changes to the items in the crosswalk below, an announcement will be made.
- The proposed waiver application will be posted for 30 days.
- Upon submission of the waiver application, CMS has 90 days to approve the waiver.
- CMS may need additional time after the 90-day approval period has expired due to recommendations for substantial changes to specific sections in the renewal application.
A crosswalk of the proposed changes in the waiver application is listed below:
The 30-day public comment period is your opportunity to provide feedback to the proposed changes. Your comments and feedback are welcome. Instructions to where to send your comments and feedback are listed below.
- Email: medciaid.capcwaiver@dhhs.nc.gov or
- Mail: Attn: CAP/C Unit; 2501 Mail Service Center Raleigh, NC 27699-2501
Oral comment and feedback, dial 919-855-4345 and leave a message.
A return response to comments or feedback will not be immediately provided. After the 30-day public posting, all comments and feedback will be compiled to include resolution of comments. The compilation of the public comments will be posted to the CAP/C webpage.
Contact: LTSS, Medicaid.capda@dhhs.nc.gov
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)
Previous Ten-Day Posting for Submission to the Centers for Medicare and Medicaid Services (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)
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 05/24/2023