DHHS SUSPENDS IMPLEMENTATION OF MANAGED CARE

The North Carolina Department of Health and Human Services yesterday announced that managed care implementation and open enrollment for NC Medicaid must be suspended. Managed care will not go live on Feb. 1, 2020.

With managed care suspended, NC Medicaid will continue to operate under the current fee-for-service model administered by the department. Nothing will change for Medicaid beneficiaries; they will get health services as they do today. Behavioral health services will continue to be provided by Local Management Entities/Managed Care Organizations. All health providers enrolled in Medicaid are still part of the program and will continue to bill the state through NCTracks.

Open enrollment had begun for part of the state in July and launched statewide in October. The North Carolina Enrollment Broker Call Center (833-870-5500) will stay open through Dec. 13, 2019 to answer questions but will no longer enroll beneficiaries in a health plan. Beneficiaries can continue to contact the Medicaid Contact Center (888-245-0179). Notices will be sent to beneficiaries informing them to continue accessing health services as they do now, rather than through new health plans.

The suspension of work and the wind-down process will begin today. Once suspended, managed care cannot easily or quickly be restarted. The department will not decide on a new go-live date until it has program authority within a budget that protects the health and safety of North Carolinians and supports the department’s ability to provide critical oversight and accountability of managed care.