RALEIGH — The North Carolina Department of Health and Human Services is delaying the implementation of the NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans until April 1, 2023.
The Department made the announcement on September 28, 2022, explaining that the postponed launch would give LME/MCOs more time to contract with additional clinicians and entities. For more information, please visit check the NC Medicaid webpage.
In an article for NC Health News Clarissa Donnelly-DeRoven explains the switch is happening for nearly 200,000 people out of a total of more than 2.8 million North Carolina Medicaid beneficiaries. The plans are targeted primarily for those with complicated health problems, severe mental health needs, intellectual and developmental disabilities, and traumatic brain injuries. It’s the next phase in the state’s transition to managed care, which started in July 2021.
Tailored plans will be different from the other managed care plans. Unlike the rest of the Medicaid population, those on tailored plans will not have four to five managed care plans to choose from. They will have no options and will automatically be enrolled in the tailored plan run by the LME-MCO that covers their county.
For mental health and other providers to keep seeing patients, they have to sign up to be in the LME-MCOs new network. If they don’t, their patient will have to find a new doctor.
The LME-MCOs have run into problems building up networks of physical healthcare providers to augment the mental health services they’ve been designed to provide. The state health department cited this on Thursday as the main reason it’s delaying the rollout of tailored plans from Dec. 1 to April 1, 2023.
The North Carolina Medical Society is here to help you and your practice navigate this transformation to how North Carolina delivers Medicaid services. If you encounter any issues related to Medicaid, please use this NCMS Form to document your concerns:
Medicaid Transformation Form – https://ncmedsoc.org/innovations-resources/medicaid-transformation/medicaid-transformation-issues-form/
The full NCDHHS release is available here: https://www.ncdhhs.gov/news/press-releases/2022/09/29/ncdhhs-delays-medicaid-managed-care-tailored-plans