NC moves ahead with managed care for Medicaid

Published 10:43 am Monday, March 12, 2018

The North Carolina Department of Health and Human Services has released a request for proposal for independent enrollment broker services that will help beneficiaries enroll in the North Carolina Medicaid and NC Health Choice managed care programs, scheduled to launch July 1, 2019.

The selected independent enrollment broker will help beneficiaries and their families understand Medicaid managed care, including choosing a health plan and primary care physician that is best for their personal situation. Enrollment broker services will be available to new beneficiaries and current beneficiaries who are transitioning from the current fee-for-service structure into managed care.

“We are continuing to move forward on operational milestones that are critical to the launch of managed care,” said DHHS Secretary Mandy Cohen. “While there is much work to be done, we are committed to implementing managed care in a way that advances the health and well-being of North Carolina families.”

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“Navigating the health care system is hard enough,” said Assistant Secretary of Medicaid Transformation Jay Ludlam. “We look forward to selecting an independent enrollment broker who will be able to provide our beneficiaries with the support they need in the enrollment process.”

The request for proposal and instructions for submissions are available on the state’s Interactive Purchasing System at The request was issued March 2, 2018.

Also released is “Managed Care Benefits and Clinical Coverage Policies,” the latest in a series of the department’s concept papers that give providers and health plans details on a specific Medicaid managed care program topic.

About a dozen concept papers will be released through early 2018. Input from beneficiaries, advocates or other interested parties are welcome and encouraged. Visit the Medicaid Transformation website to send feedback to the department:

The request for proposal and concept paper, along with the Amended Section 1115 Demonstration Waiver Application and previously released documents, are also available on the Medicaid Transformation website.