DHHS Submits Amendment to Medicaid Waiver Application


The N.C. Department of Health and Human Services today submitted to the Centers for Medicare & Medicaid Services an amendment to the 1115 Demonstration Waiver application originally submitted by North Carolina in 2016. Submitting this amended waiver application is an important next step in implementing the Proposed Program Design for Medicaid Managed Care that DHHS published in August.

“Our first priority is the health and well-being of all North Carolinians, said DHHS Secretary Mandy Cohen. “Today’s Medicaid waiver amendment is an important step in implementing a health system that improves health, value and access to care.”

“The Department’s overarching goal is to improve the health of North Carolinians through an innovative, whole-person-centered, well-coordinated system of care,” said DHHS Deputy Secretary for Medical Assistance Dave Richard. “The Department looks forward to continued collaboration and discussion with stakeholders across the state to achieve that goal.”

In September 2015, the General Assembly directed the transition of Medicaid from a fee-for-service structure to a managed care structure in North Carolina. In preparing for the transition, DHHS has worked with stakeholders and experts to refine program design and its approach to implementation. DHHS has sought feedback from potential Medicaid managed care plans and other stakeholders on options and considerations related to Medicaid managed care design.

The amended waiver submitted to CMS is a revised version of the 1115 waiver application North Carolina submitted to CMS in June 2016. The Department’s proposed program design for Medicaid managed care also includes a variety of initiatives, and today’s 1115 waiver application focuses more narrowly on the specific items that require CMS approval, including program design elements related to better integrating behavioral health and social support services with physical health services and increasing access to care in underserved communities through workforce and telehealth initiatives.

A fact sheet summarizing the key components of the waiver is available at: http://bit.ly/2n54CcQ.

A copy of the 1115 Demonstration Waiver Amendment request may be found at: http://bit.ly/2AXcf7e.

As part of the transition to managed care, DHHS published a white paper, Medicaid Managed Care Proposed Program Design earlier this month. In November, DHHS also published Behavioral Health and Intellectual/Developmental Disabilities, the first in a series of North Carolina Medicaid managed care program concept papers. These papers will be released over the next several months and provide details on specific components of the managed care program design.

For additional information about transformation efforts, https://www.ncdhhs.gov/nc-medicaid-transformation.

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