The administrative complexities of providing care to your patients now covered under Tailored Plans can be frustrating. NC Medicaid hopes to ease provider administrative burden in the transition period, and ensure that beneficiaries receive uninterrupted care.
Tailored Plans (TP) and Tailored Care Management (TCM) for Primary Care Providers (PCP) and Specialty Providers
Tailored Plans are set to launch on July 1, 2024. As a provider of physical health services, you and your teams need to know how and where to submit claims for payment of services rendered.
North Carolina Medicaid Division of Health Benefits (DHB) has announced that Tailored Plans (the health plans for qualifying members with mental health needs, substance use disorders, intellectual/developmental disabilities or traumatic brain injuries) will start on July 1, 2024.
On November 1, North Carolina Secretary of the Department of Health and Human Services, Kody Kinsey, released a directive that Local Management Entities / Managed Care Organizations (LME-MCOs) are consolidating from 6 to 4 entities (Partners Health Management, Alliance Health, Vaya Health, Trillium Health Resources).
The Department of Health and Human Services is delaying implementation of the Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans. Tailored Plan launch was scheduled for October 1, 2023, but will now go forward at a date still to be determined.
To ensure nearly 150,000 people seamlessly receive care on day one, the North Carolina Department of Health and Human Services will delay the implementation of the NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans. The launch was scheduled for April 1 and is now targeted for Oct. 1, 2023.
