Update: NC’s Move to Medicaid Managed Care

November 19, 2020

NC Medicaid recently published an update on the state’s move to Managed Care for physicians and PAs serving Medicaid patients. The transition is slated to occur on July 1, 2021, when an estimated 1.6 to 1.8 million Medicaid and NC Health Choice beneficiaries will begin receiving services through five Prepaid Health Plans (PHPs) or the Eastern Band of Cherokee Indians (EBCI) Tribal Option. Some beneficiaries will stay in fee-for-service known as NC Medicaid Direct.

The update includes:
• Links to sign up for one webinar series specifically for Medicaid Managed Care going live on July 1, 2021, and another that focuses on Quality and Performance on clinical criteria
• How to ensure provider information displays correctly in NC’s Provider Directory Tool
• Provider Ombudsman contact information
• PHP Provider Manual updates
• Key dates for transitioning to Medicaid Managed Care

Access the update here.