PHPs for NC Medicaid Managed Care - North Carolina

PHPs for NC Medicaid Managed Care - North Carolina

North Carolina Medicaid Transformation Medicaid Managed Care Update Debra C. Farrington Chief of Staff Date: 3/27/19 PHPs for NC Medicaid Managed Care Statewide contracts AmeriHealth Caritas North Carolina, Inc. Blue Cross and Blue Shield of North Carolina, Inc. UnitedHealthcare of North Carolina, Inc.

WellCare of North Carolina, Inc. Regional contract Regions 3 & 5 Carolina Complete Health, Inc. NC Medicaid Managed Care Regions and Rollout Dates Rollout Phase 1: Nov. 2019 Regions 2 and 4 Rollout Phase 2: Feb. 2020 Regions 1, 3, 5 and 6 Learn more: https://www.ncdhhs.gov/news/press-releases/dhhs-announces-prepaid-health-plan-contracts-medicaid-managed-care 3 Medicaid Transformation Timeline Timeline

Milestone February 2019 Member Educational Materials mailed June 2019 Soft Launch, Call Center open, welcome packages mailed Summer 2019 PHPs contract with providers and meet network adequacy July Sept. 2019

Open enrollment period (July 15-Sept. 13) November 2019 Managed Care Standard Plans launch in Regions 2 & 4; Phase 2 open enrollment February 2020 Managed Care Standard Plans launch in Regions 1,3,5,6 4 Current Managed Care Activities

Maximus Community based meetings Website development Welcome packet PHP onboarding Contracting Outreach to counties Meeting with Associations Reporting problems or issues

5 DSS TRAINING Managed Care Regional Trainings Complete Upcoming Training Annual Meeting 5/1/19 Wilmington SSI 7/30/19- 8/1/19 Hickory NEMT webinar Date pending 6 Ombudsman Update

Features Independent entity Assist individuals in fee for service (FFS) and managed care Four core functions Referral- FFS, LME-MCO and managed care recipients Information and Education - FFS, LME-MCO and managed care recipients Issue Resolution managed care recipients Trend Monitoring- system level RFP released Responses Due 4/12/19 Award RFP 5/24/19 7

Questions DISCUSSION NC MEDICAID TRANSFORMATION WEBSITE www.ncdhhs.gov/medicaid-transformation Contact [email protected] NC MEDICAID | MARCH 28, 2019 8

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