Dear Members and Guardians,

We aim to keep you informed about significant developments in local, state, and national Medicaid policies. According to recent communications from NC DHHS, there are ongoing LME/MCO consolidations taking place that primarily impact our Eastpointe and Sandhills members receiving services.

We have been assured that this consolidation will not result in disruptions in services or Medicaid coverage, and our LME MCO partners have been working diligently to ensure continuity of care for all persons impacted by the changes.

Communication Information:

To enhance the delivery of care, stabilize the public behavioral health system, and introduce NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plans, the North Carolina General Assembly has directed the Secretary for the North Carolina Department of Health and Human Services to reduce the number of LME/MCOs to no more than five, with a minimum of four.

On November 1, 2023, the Secretary issued a directive, stating that Sandhills Center will be dissolved. Eastpointe and Trillium Health Resources will be consolidated into one entity to serve the majority of Sandhills’ counties, with the exception of Davidson, Harnett, and Rockingham counties.

Specifically:



• Davidson County will be served by Partners Health Management.
• Harnett County will be served by Alliance Health.
• Rockingham County will be served by Vaya Health.

Subject: Important Dates and Information Regarding LME/MCO Consolidation

Timeline:

• Jan. 8, 2024 – Jan. 18, 2024: Welcome packets sent to members from the new LME/MCO.
• Jan. 8, 2024 – Jan. 20, 2023: Enrollment Broker sends new LME/MCO assignment letters to members.
• Feb. 1, 2024: Consolidation go-live (effective date of coverage under the new LME/MCO for each impacted member).

Information for Impacted Members:

To ensure a smooth transition for our members during the consolidation process, the following information will be provided:

1. LME/MCO Assignment Letter: Members will receive an LME/MCO assignment letter from the Enrollment Broker two to three weeks before the consolidation go-live date.
2. Educational Materials and Resources: A package containing new member welcome packets and Tailored Care Management (TCM) inserts (as appropriate) for their new LME/MCO. This will include the Prepaid Inpatient Health Plan (PIHP) welcome letter and member handbook, provided to impacted members before the consolidation go-live.
3. New Medicaid ID Cards: Within one week of consolidation go-live, members will receive new Medicaid ID cards with their new LME/MCO information. It's important to note that individuals can continue using their old Medicaid ID cards until they receive the new card.

We understand that changes like these may raise questions, and we are here to assist. If you have any concerns or need further clarification, please don't hesitate to reach out.