NCCOMeT Update

NC DHHS has announced that implementation of the NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plans will be delayed until April 1, 2023 instead of December 1, 2022.

Tailored Plans, originally scheduled to launch Dec. 1, 2022, will provide the same services as Standard Plans in Medicaid Managed Care and will also provide additional specialized services for individuals with significant behavioral health conditions, Intellectual/Developmental Disabilities and traumatic brain injury.

The delayed start of Tailored Plans allows Local Management Entity/Managed Care Organizations, which will operate the Tailored Plans, more time to contract with additional providers to support member choice and to validate that data systems are working appropriately. The decision is supported by the leadership of the state’s six LME/MCOs.

While the start of Tailored Plans will be delayed, specific new services will still go live Dec. 1, 2022.

NCDHHS and LME/MCOs will support providers of Tailored Care Management to launch their services on Dec. 1. Through Tailored Care Management, eligible beneficiaries will have a single designated care manager supported by a multidisciplinary team to provide integrated care management that addresses the beneficiary’s whole-person health needs.

In addition, pending approval from the Centers for Medicare and Medicaid Services, NCDHHS will implement the 1915(i) option on Dec. 1. This program provides services to help beneficiaries remain in their homes and community-based settings through services such as Respite, Individual and Transitional Supports, Community Living and Supports, Community Transition and Supported Employment.

Beneficiaries set to receive care through the Tailored Plans will continue to receive behavioral health services and I/DD and TBI supports through their LME/MCO and physical health and pharmacy services through NC Medicaid Direct, just as they do today.

More information regarding the beneficiary choice period and other key dates leading up to the April 1, 2023, launch will be shared by NCDHHS in the coming weeks.

For more information visit NC Medicaid’s Tailored Plan website.

Since it began in January 2020, the COVID-19 federal Public Health Emergency (PHE) helped prevent NC Medicaid beneficiaries from losing their health coverage during the pandemic, even if someone’s eligibility changed. The PHE also helped health care providers keep their practices running so they could deliver care to Medicaid beneficiaries.

NC Medicaid has launched a new webpage to help provide guidance on preparing for the end of the PHE. The webpage offers information and resources including a communication toolkit for community partners who work closely with beneficiaries as we work together to ensure consistent access to care. You are encouraged to share this information with your partners and stakeholders.

Preparing for the End of the COVID-19 Federal Public Health Emergency Webpage 

NC Medicaid End of COVID-19 PHE Toolkit

The federal PHE currently extends beyond Oct. 13, 2022. While we do not know when the PHE will end, NC Medicaid wants to help beneficiaries, providers and community stakeholders understand any potential impacts and steps they can take to be ready.