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Policy Papers

Final Policy Guidance

NC Medicaid Final Policy Guidance documents outline the final policies that will govern certain NC Medicaid Managed Care features or programs. The Department appreciates previous stakeholder input, which helped shape final policies. The Department reserves the right to amend or update policies as needed. Questions about the final policies are welcome. Please send an email to

Behavioral Health and Intellectual and Developmental Disability Tailored Plans Eligibility and Enrollment - March 18, 2019


Policy Papers

DHHS Medicaid Managed Care policy papers focus on NC Medicaid Managed Care program features. Policy papers typically include a public comment period. Although these technical papers are primarily written for providers and health plans that want to participate in Medicaid Managed Care, all comments are welcome and encouraged. Send an email to

North Carolina's Data Strategy for Tailored Care Management - Released Sept. 12, 2019. Please send comments to through Oct. 10, 2019.

North Carolina's Care Management Strategy for Behavioral Health and Intellectual/Developmental Disability Tailored Plans - Released May 29, 2019

Clinically Integrated Networks and Other Partners Support of Advanced Medical Homes Care Management Data Needs - Released March 5, 2019

Healthy Opportunities Pilots: A Review of Proposed Design for Interested Stakeholders - Released Feb. 15 as a companion to the Healthy Opportunities Pilots Request for Information.

North Carolina Medicaid Managed Care Updates - Released July 23, 2018

Data Strategy to Support the Advanced Medical Home Program in North Carolina - Released July 22, 2018

Supporting Provider Transition to Medicaid Managed Care - Released May 18, 2018

Prepaid Health Plans in NC Medicaid Managed Care - Released May 16, 2018

Using Standardized Social Determinants of Health Screening Questions to Identify and Assist Patients with Unmet Health-related Resource Needs in North Carolina - Released April 5, 2018

Updated Standardized Screening Questions for Health-related Resource Needs - July 9, 2018. Please use with "Using Standardized Social Determinants of Health Screening Questions..." paper released April 5, 2018, above.

North Carolina's Vision for Long-term Services and Supports under Managed Care - Released April 5, 2018

Draft: North Carolina's Medicaid Managed Care Quality Strategy - Released March 20, 2018. Please also use as a companion document to the PHP Quality Performance and Accountability concept paper.

Centralized Credentialing and Provider Enrollment - Released March 20, 2018

Provider Health Plan Quality Performance and Accountability - Released March 20, 2018

North Carolina's Care Management Strategy under Managed Care - Released March 9, 2018 

Beneficiaries in Medicaid Managed Care - Released March 9, 2018 

Managed Care Benefits and Clinical Coverage Policies - Released March 2, 2018 

Prepaid Health Plan Network Adequacy and Accessibility Standards - Released Feb. 15, 2018

Addressing Hospital Supplemental Payments in the Transition to Managed Care - Released Nov. 20, 2017

Behavioral Health and I/DD Tailored Plan Concept Paper - Released Nov. 9, 2017

Population Profiles - Released Nov. 9 as a companion document to the Behavioral Health I/DD Tailored Plan Concept Paper.