June 2, 2021

Vaya Health & Cardinal Innovations Announce Consolidation

Many of you have likely seen the attached announcement from Vaya and Cardinal LME-MCOs.  We appreciate the boards of both Vaya and Cardinal working quickly to identify a solution to stabilize Cardinal after additional counties voted to disengage from Cardinal.  We believe this action will provide stabilization for the overall North Carolina Public Behavioral Health and I/DD system.

While there are a number of details still to be finalized, DHHS wants to update you of the following:

  • Beneficiaries will continue to receive their services and supports. Medicaid In lieu of services and DMH alternative services currently in place will continue to be provided and we anticipate those services will be approved to be available in the entire new Vaya catchment area.   
  • Providers will not see any changes to their rates during this transition and all providers in good standing currently in network will continue to be in network in the consolidated entity.
  • The counties that have been approved to disengage will continue in that process. Counties that have voted to disengage will have their request reviewed in accordance with the disengagement rules. Any other county served by Cardinal that would request disengagement in light of the consolidation announcement may do so. Vaya is already planning immediate outreach activities to counties in the Cardinal catchment area, though counties are welcome to have conversations with other LME-MCOs. We ask counties that these conversations happen rapidly.
  • DHHS will work closely with the leadership of each organization to execute this consolidation. Although the final consolidation may take up to a year, the transition to Vaya oversight will happen over a shorter period. We will continue to keep you informed about the progress of the consolidation during the weeks and months to come. Vaya and Cardinal are also committed to providing information and communication rapidly and consistently.

 

Below is a statement that DHHS provided to the press in response to inquiries about the consolidation.

“DHHS has been actively engaged to ensure the thousands of consumers currently served by Cardinal Innovations continue to receive needed supports and services. The decision of Mecklenburg County to vote to request disengagement from Cardinal Innovations and the recent vote by Forsyth County to disengage from Cardinal introduced uncertainty and instability for the Cardinal organization and those they serve. We appreciate the boards of Vaya and Cardinal working rapidly to reach an agreement to consolidate to provide stability for beneficiaries and families. We will work closely with the boards and staff of each organization to better understand and work through the details of this transition.

There is still much work to be done. DHHS will continue to work with the counties who have requested disengagement and work with the NCACC to determine if additional counties are considering disengagement and the best process for moving forward. Throughout the process we will actively engage consumers, families, and providers for input.“

Thank you for your ongoing partnership in supporting our consumers and families through these changes. We will continue to provide updates and additional information as they are available.

— Dave

 

April 29, 2021

NC Medicaid Managed Care Fact Sheet: “Do I Need to Choose a Health Plan?”

Good afternoon, NC Medicaid Associations:

With NC Medicaid Managed Care Open Enrollment ending May 14, you may hear from beneficiaries who are unsure if they need to choose a managed care health plan. To help answer this question, NC Medicaid has added a “Do I Need to Choose a Health Plan?” fact sheet (attached and also in Medicaid County and Provider Playbooks at medicaid.ncdhhs.gov/transformation).

The fact sheet outlines the groups of beneficiaries that must, may or cannot choose a managed care health plan during Open Enrollment. It also includes contact information for the NC Medicaid Enrollment Broker Call Center (833-870-5500 or ncmedicaidplans.gov) if beneficiaries have additional questions.

For more information about NC Medicaid Managed Care, visit the Medicaid Transformation website at medicaid.ncdhhs.gov/transformation or the NC Medicaid Enrollment Broker website at ncmedicaidplans.gov.

— Dave

 

OPEN ENROLLMENT ANNOUNCEMENT:

PHP Selection by County

April 19, 2021

Dear DSS Directors:

Preparations are underway for NC Medicaid Managed Care launch on July 1, 2021, so we have resumed the NCMT DSS County Communication to keep you informed. This platform will be used to share issues raised, how issues are being resolved and guidance for addressing issues with beneficiaries. We are committed to resolve problems quickly and make sure beneficiaries, providers, and county agencies have the support they need. This communication will be posted in NC FAST Help at Economic Services>Medicaid Transformation>Communications. Please see below for this week’s update. 

 PHP Selections by County Report

In response to your request for information on the number of beneficiaries who have already selected a health plan, on April 12 you began receiving a report that is run each Monday and included with this weekly communication.  Please see the latest report dated April 19 shows enrollment as of April 18. The report lists by county:

  • total beneficiaries moving to managed care
  • total beneficiaries who have a PHP selection
  • total beneficiaries with a selection as a percentage of the total who will transition to managed care on July 1, 2021 

Any beneficiary transitioning to managed care who does not make a health plan selection by May 14 (end of Open Enrollment period) will be auto-enrolled in a health plan beginning May 15, 2021.

 Reminder Postcards Are Being Mailed

We have reached the midpoint of open enrollment. Reminder postcard mailings started Thursday, April 15, and will continue over the next 10 business days. This may cause an increase in beneficiary contact with your agency. Please ensure staff are aware of the postcard, which is located in the NC Medicaid Managed Care County Playbook under Beneficiary Notices.

 NC Medicaid Transformation DSS Training Course Recordings

The seven webinar modules of the NC Medicaid Transformation DSS Training Course have been recorded and are available on the NC FAST Learning Gateway at the following location: Courses>OST Training>OST Special Webinars and Courses>NC Medicaid Transformation DSS Training or at the direct link: https://ncfasttraining.nc.gov/course/view.php?id=1175.

As always, thank you for your partnership in serving the citizens of North Carolina!

Carolyn McClanahan

 

NC Medicaid Associations:

NCDHHS announced today the launch of statewide open enrollment for NC Medicaid Managed Care. Beneficiaries can enroll through one of four channels: online, by calling the NC Medicaid Managed Care Call Center at 833-870-5500 (TTY: 833-870-5588), through the free NC Medicaid Managed Care mobile app available on Google Play or the App Store, or by using the mail-in forms sent to them in an enrollment packet.

The NC Medicaid Managed Care website offers a wide variety of tools and resources to assist beneficiaries in choosing a primary care provider (PCP) and a health plan for their families’ care. Resources include frequently asked questions, a chat function, and the Medicaid and NC Health Choice Provider and Health Plan Lookup Tool. The Lookup Tool offers four categories of search capabilities, advanced search based on specialty and the ability to view all providers within an organization/location and by practice name.

A variety of public communications will be utilized, including television and radio ads, web and social media to inform beneficiaries of the enrollment channels that are available through May 14, 2021, when open enrollment ends.

 

NC Medicaid Managed Care County Playbook

The following materials have been added to the NC Medicaid Managed Care County Playbook and are available for review. Please review the new material with your staff.  (COUNTIES ARE ENCOURAGED TO REVIEW THE PLAYBOOK REGULARLY FOR UPDATES.)

NEMT:

Fact Sheet – Introduction to Medicaid Transformation Part 1: Overview
Fact Sheet – Introduction to Medicaid Transformation Part 2: Enrollment & Timelines
Fact Sheet – Non-Emergency Medical Transportation (NEMT): Part 1
Fact Sheet – Non-Emergency Medical Transportation (NEMT): Part 2
NEMT Claims by County & Provider from NC Tracks 12212020

ENROLLMENT BROKER:

EB County Liaison Specialists Contact Information Update

NC Medicaid continues to prepare for the launch of NC Medicaid Managed Care on July 1, 2021. As previously discussed, the enrollment broker will be providing virtual support to local DSS offices throughout the transition to Managed Care. Beginning Friday, February 19, enrollment broker resources will be reaching out to DSS directors to inform you of your assigned County Liaison Specialist and contact information. Full county support is targeted to begin March 1. Please check your email for this important information.

PHP:
DSS RECONNECT 12 14 20 MASTER DECK

ADDITIONAL MEDICAID TRANSFORMATION INFORMATION:

NCMT_TIMELINE_2020
NCMT_MEDICAID MANAGED CARE NEMT POLICY GUIDANCE_2020_0601
20201027 NCMT_COUNTY DSS SUPPORT PLAN
DHB POINT of CONTACT

NC Medicaid Managed Care Video and Vignettes  

NC Medicaid Managed Care Introductory video and vignettes, available in both English and Spanish, have been posted to the NC Medicaid Managed Care Playbook.  DSS offices with the capability to show videos in your agencies may be interested in using the Enrollment Broker’s informative video on Managed Care in your waiting rooms and on your agency social media platforms. Videos are made to be shown with or without sound.

The four-minute video educates beneficiaries about the new Medicaid program, including health plan options and what they need to do. It has also been split into three shorter vignettes with each focusing on individual pieces of information for your use. 

Managed Care Status Counts Report by County

To provide counties with a current snapshot of the managed care statuses for their Medicaid beneficiaries, a report titled 20210201 Managed Care Status Counts Report by County has been posted to NC FAST Help at Economic Services>Medicaid Transformation.

County Readiness: NCMT Readiness Considerations Workbook

To help support county staff, the NCMT Readiness Considerations Workbook was updated and sent to counties via listserv message on February 15. This is an internal tool to help DSS prepare for the transition to managed care. It is requested the county complete this workbook and submit to their Medicaid Operational Support Team (OST) representative by March 1. The workbook has also been posted to the NC Medicaid Managed Care County Playbook under DSS Role in Managed Care.

Reminder: Outreach Materials Scheduled to be Shipped to DSS

NC Medicaid Managed Care posters and palm cards are expected to begin shipping to the physical DSS addresses on February 19 with delivery completed by March 1. Please alert the appropriate staff in your agency who are responsible for receiving deliveries.

NCDHHS Social Media Campaign to Begin 3/1

NCDHHS will utilize social media – Facebook, Twitter and Instagram – to inform beneficiaries of NC Medicaid Managed Care updates and key messages. DSS offices are encouraged to “follow” NCDHHS on each platform and use the “share” or “retweet” features to reach your local beneficiaries.

Facebook: https://facebook.com/ncdhhs

Twitter: https://twitter.com/ncdhhs

Instagram: https://instagram.com/ncdhhs

NCDHHS has developed the social media plan below for March 2021. Please note that this timeline is subject to change.

Timeline Social Media Content
3/1/21
  • NC Medicaid Managed Care Call Center
  • NC Medicaid Managed Care Website
3/1/21-3/5/21
  • EBCI Tribal Option
3/8/21-3/10/21
  • Open Enrollment (upcoming)
3/15/21
  • Open Enrollment (start)
3/15-3/31/21
  • NC Medicaid Managed Care Overview
  • NC Medicaid Managed Care Mobile App
  • Choosing a primary care provider (PCP) and health plan