dma.ncdhhs.govNC Medicaid

Did you know that your browser is out of date? Your browser is out of date and may not be able to properly display our website. Update my browser now to experience this site. Skip to main content Disclaimer Select Language ​ ▼ Search NC.gov Menu NC DHB Search Close Menu Topical Navigation Home Medicaid Transformation Meetings and Notices Find a Doctor Providers Counties Reports About Us Enterprise Navigation NC DHHS NC.gov Agencies Jobs Services Home Celebrates 50 Years This year marks the 50th anniversary of North Carolina’s Medicaid program, which provides health coverage for low-income adults, children, pregnant women, seniors and people with disabilities throughout the state. Learn More 2 of 2 DHHS Suspends Implementation of Medicaid Managed Care Beneficiaries get Medicaid physical and behavioral health services as they do now. They do not need to choose a health plan. Medicaid providers submit claims through NCTracks as they do today, and should continue contracting with health plans. Questions & Answers for Beneficiaries 3 of 2 What We Do (Division of Health Benefits) is dedicated to providing access to physical and behavioral health care and services to improve the health and well-being of over 2.1 million North Carolinians on behalf of the North Carolina Department of Health and Human Services. manages the state's Medicaid and NC Health Choice health care programs, pharmacy benefits, and behavioral health services. Medicaid is the program that provides health coverage to eligible low-income adults, children, pregnant women, seniors and people with disabilities. The program is jointly funded by North Carolina and the federal government. NC Health Choice is our state’s name for the Children’s Health Insurance Program (CHIP). It provides health coverage to eligible children in addition to Medicaid. This program also is jointly funded by North Carolina and the federal government. LME-MCOs are local management entities-managed care organizations that contract with to provide behavioral health and intellectual/development disability services to Medicaid beneficiaries. In addition, also oversees community alternatives programs for children and disabled adults, home health care, and helping people transition from nursing homes to live in their own communities—and more. It also works closely with the North Carolina Department of Justice to identify and prosecute fraud, waste and abuse of the Medicaid program. We are proud of our commitment to be good stewards of taxpayer money while continuing to provide valuable health programs and services to the Medicaid population. This is an enormous responsibility, one that we are honored to share with our state and local partners. At , our staff comes to work each day knowing that our contributions make a real difference in the lives of North Carolinians and the communities in which we all live and work. Notice about Managed Care With Medicaid Managed Care suspended, will continue to operate under the current fee-for-service model administered by the Department. 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 Medicaid Managed Care. Beneficiaries: Continue using Medicaid services as you do today. You do not need to enroll in a health plan at this time. Look for a notice to arrive in the mail with details. Call the Medicaid Contact Center at 888-245-0179 if you have questions about Medicaid Managed Care. Medicaid Managed Care Questions & Answers for Beneficiaries Providers: Auto-assignment has been suspended; however, you should continue to contract with health plans. Call the Medicaid Contact Center at 888-245-0179 if you have questions about Medicaid Managed Care. Procurement: Procurement efforts currently underway are expected to continue. There may be changes in the timing or schedule. Background In 2015, the NC General Assembly enacted legislation directing the Department to transition North Carolina Medicaid and NC Health Choice from fee-for-service to managed care. Under managed care, the state contracts with insurance companies, which are paid a predetermined set rate per person to provide all services. The Department was on track to launch managed care Feb. 1, 2020. New funding and program authority were required from the General Assembly to meet this timeline. The General Assembly adjourned in November 2019 without providing new spending and program authority required for the transition to managed care. Getting Medicaid or Health Choice Medicaid serves low-income parents, children, seniors, and people with disabilities. Provider Information Service specific information for North Carolina Medicaid and Health Choice providers. Get Involved See Medicaid and Health Choice public notices, comment on proposed policies, or report fraud. NCTracks NCTracks, the multi-payer Medicaid Management Information System for the NC Department of Health and Human Services. State Plan The North Carolina Medicaid State Plan outlines the organization and function of . Find Out More Enrollment and Financial Reports Getting Medicaid Medicaid Bulletin Medicaid Managed Care Enrollment Medicaid Transformation Medical Care Advisory Committee Public Comments on Rules and Policies Report Fraud, Waste or Abuse Your Rights Share this page: Facebook Twitter Back to top Get Email Alerts Stay up to date with us. Get email alerts on latest news and upcoming events. Email Address: This field is required Contact Information Division of Health Benefits 2501 Mail Service Center Raleigh , NC 27699-2501 Contact Center Phone: 888-245-0179 Monday-Friday 8 a.m. to 5 p.m. Closed on State holidays. More Census 2020 Recent Tweets Tweets by @ncdhhs Follow Us Twitter RSS YouTube LinkedIn Facebook Employee Directory Accessibility Terms of Use Privacy Policy NC Open Budget...