Committees and Work Groups

NC Medicaid is committed to working with beneficiaries, caregivers, providers, associations and other stakeholders to improve health care in North Carolina. Below is information on  committees and work groups engaged in this collaborative process. Click on a group title for more information.

Connecting Communities & Medicaid

Connecting Communities and Medicaid (CCM) is a workgroup whose mission is to foster meaningful partnerships and drive collaborative solutions that improve access to care and address drivers of health. Through education, community and partner engagement, and policy discussions, we strive to empower communities, eliminate health disparities, and ensure Medicaid beneficiaries receive comprehensive, person-centered support.
La información en español sobre el Grupo de Trabajo de Conexión de Comunidades y Medicaid está disponible aquí.

Dual Eligibles Advisory Committee

The Dual Eligibles Advisory Committee, established according to Session Law 2015-245, provides advice to the NC Medicaid as it develops a long-term strategy to cover dual eligibles under NC Medicaid Managed Care.  

HIV Case Management

HIV Case Management is a client-focused strategy that provides cost-effective, medically necessary services to enhance beneficiary health status and level of functioning.

Medicaid Advisory Committee and Beneficiary Advisory Council (MAC and BAC)

The Centers for Medicare & Medicaid (CMS) released its final rule, “Ensuring Access to Medicaid Services” which requires NC Medicaid and other State Medicaid agencies to create a Medicaid Advisory Committee (MAC) and Beneficiary Advisory Council (BAC) by July 2025.* 

The MAC/BAC is designed to center the lived experience of beneficiaries, their families and caregivers and will provide a more formalized structure for beneficiaries and interested parties to provide feedback to the state about Medicaid.

Medical Care Advisory Committee (MCAC)

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 Medicaid.

Money Follows the Person (MFP)

Money Follows the Person (MFP) is a state project that helps Medicaid-eligible North Carolinians who live in inpatient facilities move into their own homes and communities with support. If you are interested in receiving MFP updates and meeting notices, please email us at mfpinfo@dhhs.nc.gov.

North Carolina Drug Utilization Review Board

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.  

Personal Care Services (PCS) Stakeholder Group

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. NC Medicaid meets bi-monthly with community stakeholders to share project status, gather input and identify the next steps.

Preferred Drug List (PDL) Review Panel

The Medicaid Preferred Drug List (PDL) Review Panel was established to conduct open meetings to discuss recommended policies and procedures related to the PDL and to address public comments received during the PDL comment period. The administration and review of the North Carolina Medicaid PDL follows the Preferred Drug List Review Panel Guidelines and Procedures.

Primary Care Payment Task Force

The Task Force was legislated in 2023 in SL 2023-134 and supports the development of the definition for primary care, an understanding of current spending on primary care services and an assessment of the current state of primary care in North Carolina. The Task Force will develop a definition of primary care for the work to deliver a report to the Joint Legislative Oversight Committee on Health and Human Services and the Joint Legislative Oversight Committee on Medicaid no later than April 1, 2024. The findings and recommendations in the report will include specific, concrete and actionable steps to be undertaken by the State and upon which the General Assembly can act.

Private Duty Nursing (PDN) Stakeholders

Private Duty Nursing (PDN) is a 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.