NC Medicaid Reform

A collage of photos of patients and medical service providers

Jan. 31, 2017 - The Department of Health and Human Services submitted its managed care strategy for dual eligibles report (Session Law 2015-245, Section 5(11)) to the NC Joint Legislative Oversight Committee on Medicaid and NC Health Choice. The Session Law also requires the Department to form a Dual Eligibles Advisory Committee, which has met monthly from June 2016 through January 2017. This committee of external advocates, providers, associations and beneficiaries provided valuable insight, perspective and expertise that substantially contributed to strategy development. The Department will continue to engage the Advisory Committee throughout the process of transitioning dual-eligible beneficiaries to managed care. 

Dec. 7, 2016 - April 12, 2017 - The Department of Health and Human Services has engaged the NC Institute of Medicine (NCIOM) to lead the Task Force on Health Care Analytics. The Task Force will define and prioritize specific quality improvement measures of health and health care to be used by Medicaid to improve health in North Carolina. Visit the NCIOM website for Task Force meeting dates, members and other details.

Oct. 1, 2016 - Per Session Law 2016-121, the Department submitted its Medicaid reform progress report to the NC Joint Legislative Oversight Committee on Medicaid and NC Health Choice. This report provides an update on Department Medicaid reform activities, including Section 1115 waiver application status, the Medicaid transformation work plan and how the federal Managed Care Final Rule impacts the waiver application.

June 20 - July 20, 2016 - The federal Centers for Medicare & Medicaid Services held its public comment period on the North Carolina Medicaid reform plan (Section 1115 demonstration) application.

June 1, 2016 - North Carolina's Medicaid Reform plan (Section 1115 demonstration) application was submitted to the federal Centers for Medicare & Medicaid Services (CMS). Over the next 18 months or so, CMS will review the application and discuss the reform plan in detail with the Department of Health and Human Services.

* * *

Over the next 3 to 4 years, the NC Department of Health and Human Services will work closely with people who receive Medicaid services and their families, and with those that provide Medicaid and NC Health Choice services (like doctors and hospitals) to build the new Medicaid health care system. In the meantime, the Medicaid program will continue as usual and beneficiaries will receive care the same way they do now.

When Medicaid Reform is ready and approved by the federal government, it will be the right health care system for North Carolina – one that puts people first.

Keep visiting this Medicaid Reform website for updates.