Behavioral disability plans suspended until April

On September 29, North Carolina Medicaid announced that it would delay the implementation of the December 1 through April 1 customized behavioral health and intellectual disability/developmental disability plans.

This decision was made with the support of the managed care organizations to ensure beneficiaries can be seamlessly cared for on day one.

Just as Medicaid members and federally funded recipients do today, they will continue to receive serious behavioral health services, I/DD services, and traumatic brain injury support from Trillium.

Members will continue to receive health and pharmacy services through NC Medicaid Direct through April 1.

Trillium will continue to contract with vendors, provide necessary employee training and meet readiness requirements during this time. The company will provide more information on any changes this delay may bring in the coming weeks.

“Trillium and our Standard Plan partner, Carolina Complete Health, have added additional providers so our members can continue to see healthcare professionals and use healthcare facilities as they are today,” said Joy Futrell, Trillium CEO. “These additional months give us more time to ensure continuity of care for all we serve.”

There are two exceptions to this delay:

Tailor-made care management begins December 1st for eligible Medicaid members.

The new 1915(i) services will also go live December 1, subject to approval by the Centers for Medicare and Medicaid Services.

North Carolina Medicaid and MCOs will support providers of customized care management to launch their services on December 1st.

Through bespoke care management, beneficiaries have a single designated care manager, supported by a multidisciplinary team to provide integrated care management that addresses the beneficiary’s health care needs.

Information regarding TCM will be sent to eligible members shortly.

Medicaid will also implement the new 1915(i) option to help beneficiaries remain in their homes and community-based facilities.

Available services include:

reprieve

Individual and transitional aid

Community life and support

Community Transition

Supported Employment

North Carolina Medicaid will announce a new selection period for members to choose a primary care physician in 2023.

If members have already selected their PCP, their selection will be retained.

Welcome packages for members and recipients containing manuals, letters, and Medicaid ID cards will be mailed next year.

Tailored plans serve individuals with significant behavioral health needs and I/DDs, as well as other demographics, including Innovations Waiver and TBI members and waitlist members. Custom Plans are also responsible for administering the state’s non-Medicaid behavioral health, developmental disabilities, and TBI services for uninsured and underinsured recipients.

Certain services, such as B. mobile crises, will be available to all population groups regardless of insurance.

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