NC DHHS Puts More Meat on Medicaid Transformation Bones
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By all accounts, there is a lot going on in preparation for moving Medicaid physical healthcare to a managed care model. The General Assembly passed State Law 2018-48, which provided additional direction to NC DHHS on Medicaid Transformation and specifically allowed for the Standard Plan to include the mild-to-moderate behavioral health Medicaid population. NC DHHS has announced that it is in a "Silent Period" on issues related to the Request for Proposals on the Standard Plan "from now through the award of the PHP contracts...to ensure all respondents have a fair and equitable opportunity to submit a proposal to be part of Medicaid Managed Care in North Carolina."
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i2i Collaborative on Value Based Payment and Contracting Progresses
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A central focus of the i2i Center is to convene collaboratives on pressing statewide issues. As earlier reported, i2i Center has begun a collaborative on Value-Based Payment and Contracting. North Carolina has a six year history of managed care in behavioral health and intellectual-developmental disability, yet only about 3% of the contracts between LME/MCOs and providers are value-based. In discussion with plan managers and providers, it is easy to glean that the commitment to increasing quality care is evident, but that there are contractual and process barriers.
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NC Awards Medicaid Managed Care Enrollment Assistance Contract
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Maximus Inc. has been awarded the contract to provide North Carolina's Medicaid managed care enrollment and eligibility services. Here is how they describe these services on their website.
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Changes to Risk Categories for BH/I-DD Providers May Lead to Increased Access in Medicaid
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The federal Centers for Medicare and Medicaid Services (CMS) requires that all Medicaid providers be classified into one of 3 risk categories in relationship to the potential for fraud - limited, moderate, or high - and gives states the flexibility to determine the most appropriate categories of risk for providers. It is important to note that the risk that the federal government is addressing in these requirements is specifically related to program integrity, i.e. the potential for Medicaid fraud, abuse and waste by a provider. Unlike other states, for many years, North Carolina has had a blanket policy that BH/I-DD providers of any type, with the exception of ICF/MR facilities, are in the high risk category. In this short legislative session, the NC General Assembly moved some BH/I-DD providers to lower risk categories.
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New i2i Initiative on Community Inclusion
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The i2i Center for Integrative Health
is launching a new initiative to promote community inclusion for people with mental illness. The initiative is called, I'm IN: Community Inclusion. This is a joint project of i2i Center for Integrative Health, Alliance Behavioral Healthcare, and the NC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services.
The goal of I'm IN is to put into place more policies, programs, and practices that support individuals with mental illnesses so that they may participate more fully in the activities that define everyday community life. The initiative will address the harsh reality that many people with serious mental illness are unemployed and may have fragile connections to the mainstream of community life.
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Sponsored News
A System Constant - the Need for Exceptional Care
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For professionals who serve individuals with intellectual and developmental disabilities, it would be the understatement of the year to say, "Our industry is changing." Just like in many fields, the way we do business in 2018 looks very different than the way it looked ten, five or even one year ago. However, one thing remains constant, and that's the need to provide exceptional care to support the individuals who deserve our best. That's why the mission of the Community Based Care (CBC) family of providers, is to support people with intellectual and developmental disabilities (I/DD), and their families, to achieve their fullest potential by matching them with the most talented, well-trained and compassionate caregivers anywhere. It's that mission that drives us every day regardless of the changing environment around us.
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Federal Legislative Proposals Related to Medicaid and Opioids: What to Watch
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