DHHS Releases Paper on Provider Transition to Medicaid Managed Care


The North Carolina Department of Health and Human Services today released a policy paper with information for health care providers regarding the transition to Medicaid managed care, expected to launch in 2019. 
The policy paper “Supporting Provider Transition to Medicaid Managed Care” describes what Medicaid providers should expect during their transition to managed care, including guidance on enrolling and credentialing, contracting with health plans and meeting Advanced Medical Home requirements. Providers must participate in managed care to continue receiving reimbursement for serving Medicaid beneficiaries enrolled in managed care plans.
To support providers in their move to Medicaid managed care, the department is committed to reducing administrative burden whenever possible. Among those initiatives will be a centralized provider enrollment and credentialing process, described in this paper.
“We appreciate the significant number of North Carolina providers dedicated to caring for Medicaid beneficiaries,” said DHHS Secretary Mandy Cohen, M.D. “Supporting those providers as they transition to the managed care environment will help limit disruption to beneficiary treatment and services, and to provider business operations.”
The department encourages providers to attend a “Provider Transition to Medicaid Managed Care” webcast, which will be offered three times: June 8, 3-4 p.m.; June 11, 1-2 p.m.; and June 14, 3-4 p.m. Registration is required. To register and select which date to participate, go to: https://www.ncdhhs.gov/medicaid-transformation.
DHHS invites stakeholders to provide input by sending an email to Medicaid.Transformation@dhhs.nc.gov by June 11, 2018. Visit the DHHS Medicaid Transformation website to learn more about the Medicaid and NC Health Choice transformation to managed care: https://www.ncdhhs.gov/medicaid-transformation.

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