Policy Papers
Policy Guidance
NC Medicaid Final Policy Guidance documents outline the final policies that will govern certain NC Medicaid Managed Care features or programs. The Department appreciates previous stakeholder input, which helped shape final policies. The Department reserves the right to amend or update policies as needed. Questions about the final policies are welcome. Please send an email to Medicaid.NCEngagement@dhhs.nc.gov.
- Behavioral Health I/DD Tailored Plan Criteria Review Update on Eligibility and Enrollment - Updated March 2024
- Appendix B - Behavioral Health I/DD tailored Plan Criteria - Updated April 2024
- NCDHHS Transition of Care Policy - Feb. 25, 2021
- Behavioral Health I/DD Tailored Plan Memo on State-Funded Services Design Updates - Aug. 20, 2020
- Behavioral Health Crisis System Memo for Standard Plans - March 6, 2020
Policy Papers
DHHS Medicaid Managed Care policy papers focus on NC Medicaid Managed Care program features. Policy papers typically include a public comment period. Although these technical papers are primarily written for providers and health plans that want to participate in Medicaid Managed Care, all comments are welcome and encouraged. Please send an email to Medicaid.NCEngagement@dhhs.nc.gov.
- Ensuring Access to Gene Therapies to Address Sickle Cell Disease in Medicaid - Feb. 19, 2024
- Collaborative Care Model in North Carolina Policy Paper - Dec. 8, 2023
- Medicaid Delivery Reform and Value-Based Payment Market Update - Nov. 17, 2022
- North Carolina’s Specialized Foster Care Plan - Feb. 11, 2021
- Transition of Care Draft Policy - Released Feb. 5, 2020.
- Política de transición de la atención médica - Released Feb. 5, 2020.
- Behavioral Health I/DD Tailored Plan Request for Applications (RFA) Pre-Release Policy Paper - Released Jan. 30, 2020.
- North Carolina’s Value-Based Payment Strategy for Standard Plans and Providers in Medicaid Managed Care - Released Jan. 8, 2020.
- North Carolina’s Medicaid Accountable Care Organizations for Standard Plans and Providers: Building on the Advanced Medical Home Program to Drive Value-Based Payment - Released Jan. 8, 2020.
Archives
Tab/Accordion Items
Policy Guidance
- Behavioral Health and Intellectual and Developmental Disability Tailored Plans Eligibility and Enrollment - March 18, 2019
- Behavioral Health I/DD Tailored Plan Memo on Eligibility and Enrollment Updates - July 16, 2019 (update to March 18, 2019, final policy guidance)
- Request to Stay in NC Medicaid Direct and LME/MCO: Provider Attestation Form - July 16, 2019
- Request to Stay in NC Medicaid Direct and LME/MCO: Beneficiary Attestation Form - July 16, 2019
Policy Papers
- North Carolina’s Design for State-funded Services Under Behavioral Health and Intellectual/Developmental Disability Tailored Plans - Released Dec. 30, 2019.
- North Carolina's Data Strategy for Tailored Care Management - Released Sept. 12, 2019.
- North Carolina's Care Management Strategy for Behavioral Health and Intellectual/Developmental Disability Tailored Plans - Released May 29, 2019
- Clinically Integrated Networks and Other Partners Support of Advanced Medical Homes Care Management Data Needs - Released March 5, 2019
- Healthy Opportunities Pilots: A Review of Proposed Design for Interested Stakeholders - Released Feb. 15 as a companion to the Healthy Opportunities Pilots Request for Information.
Policy Papers
- North Carolina Medicaid Managed Care Updates - Released July 23, 2018
- Data Strategy to Support the Advanced Medical Home Program in North Carolina - Released July 22, 2018
- Supporting Provider Transition to Medicaid Managed Care - Released May 18, 2018
- Prepaid Health Plans in NC Medicaid Managed Care - Released May 16, 2018
- Using Standardized Social Determinants of Health Screening Questions to Identify and Assist Patients with Unmet Health-related Resource Needs in North Carolina - Released April 5, 2018
- Updated Standardized Screening Questions for Health-related Resource Needs - July 9, 2018. Please use with "Using Standardized Social Determinants of Health Screening Questions..." paper released April 5, 2018, above.
- North Carolina's Vision for Long-term Services and Supports under Managed Care - Released April 5, 2018
- Draft: North Carolina's Medicaid Managed Care Quality Strategy - Released March 20, 2018. Please also use as a companion document to the PHP Quality Performance and Accountability concept paper.
- Centralized Credentialing and Provider Enrollment - Released March 20, 2018
- Provider Health Plan Quality Performance and Accountability - Released March 20, 2018
- North Carolina's Care Management Strategy under Managed Care - Released March 9, 2018
- Beneficiaries in Medicaid Managed Care - Released March 9, 2018
- Managed Care Benefits and Clinical Coverage Policies - Released March 2, 2018
- Prepaid Health Plan Network Adequacy and Accessibility Standards - Released Feb. 15, 2018
Policy Papers
- Addressing Hospital Supplemental Payments in the Transition to Managed Care - Released Nov. 20, 2017
- Behavioral Health and I/DD Tailored Plan Concept Paper - Released Nov. 9, 2017
- Population Profiles - Released Nov. 9 as a companion document to the Behavioral Health I/DD Tailored Plan Concept Paper.
This page was last modified on 04/29/2024