Tailored Plan Implementation Delayed Until April 1, 2023
GASTONIA, N.C., SEPTEMBER 29, 2022 – The North Carolina Department of Health and Human Services (NCDHHS) will delay the implementation of the NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans (Tailored Plans) until April 1, 2023. The decision is unanimously supported by the leadership of the state’s six Local Management Entity/Managed Care Organizations (LME/MCOs).
Tailored Plans, originally scheduled to launch Dec. 1, 2022, will provide specialized services for individuals with significant behavioral health conditions, intellectual/developmental disabilities (I/DDs), and traumatic brain injuries (TBI), as well as physical health and pharmacy services.
Partners members who will be eligible for the Tailored Plan will continue to receive their behavioral health services and I/DD and TBI supports through Partners and their physical health and pharmacy services through NC Medicaid Direct, just as they do today.
The delayed start of Tailored Plans allows LME/MCOs, which will operate the Tailored Plans, more time to contract to expand their provider networks to support member choice and to validate that data systems are working appropriately.
While the start of Tailored Plans will be delayed, specific new services will still go live Dec. 1. NCDHHS and LME/MCOs will support providers of Tailored Care Management to launch their services on Dec. 1. Through Tailored Care Management, members will have a single designated care manager supported by a multidisciplinary team to provide integrated care management that addresses the member’s whole-person health needs.
In addition, pending approval from the Centers for Medicare and Medicaid Services (CMS), NCDHHS will implement the 1915(i) option on Dec. 1. This program provides services to help members remain in their homes and community-based settings through services such as Respite, Individual and Transitional Supports, Community Living and Supports, Community Transition and Supported Employment.
More information regarding the beneficiary choice period and other key dates leading up to the April 1, 2023, launch will be shared by NCDHHS in the coming weeks.
For more information about Tailored Plans please visit Partners’ website.
Partners Health Management is a leading local managed care organization (LME/MCO), providing access to care for central and western North Carolina’s most vulnerable citizens. Partners manages all Medicaid, state and local funding for intellectual/developmental disabilities, mental health and substance use disorder (IDD/MH/SUD) services in our covered areas.
We are recognized across North Carolina for our Partners Community Model and unwavering commitment to the counties and the families we serve. Through our steadfast community focus and longstanding partnerships with local stakeholders, agencies and elected officials, our members receive the care and support they need.