MM Curator summary
North Carolina is set to roll out managed care for the first time this July.
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
The ambitious Medicaid transformation initiative remains on track for a July 1 debut, state health officials told legislators Tuesday.
Dave Richard, the state’s deputy secretary for Medicaid, said that “we’re on target, we’re on schedule and our commitment to you is that we’re going to do everything possible” to go live with the managed care plans.
At stake with Medicaid transformation: three-year prepaid health plan contracts for four insurers that are projected to be worth $6 billion a year starting with the 2021-22 fiscal year which begins July 1.
With two optional one-year extensions, a contract could be worth a total of $30 billion — among the largest vendor contracts awarded in state history.
The state Department of Health and Human Services announced in February 2019 that the four PHPs are Centene (operating as WellCare of N.C.), AmeriHealth Caritas N.C., Blue Cross and Blue Shield of N.C. (operating as Healthy Blue) and UnitedHealth Group.
The next rollout steps are an online tool launching Jan. 25 that lists providers and the four PHPs, and insurers submitting their tailored plans by Feb. 2.
Statewide enrollment is projected to begin March 15 and end May 14. There is a 90-day “change period” that allows beneficiaries to switch PHPs.
