Statement from NCDHHS on Superior Court Medicaid Managed Care Ruling

Raleigh

The North Carolina Department of Health and Human Services is pleased that yet another court ruling has affirmed the integrity and fairness of the department’s Medicaid Managed Care procurement process. On Feb. 18, a Superior Court ruled in favor of NCDHHS in response to a legal challenge from one of the entities that was not awarded a contract under the state’s Medicaid Managed Care procurement process. Following arguments on My Health by Health Providers’ Petition for Judicial Review, Superior Court Judge Michael O’Foghluda ruled against My Health and in favor of NCDHHS, upholding Administrative Law Judge Tanisha Jacob’s grant of summary judgment to the department. This ruling comes after Aetna’s petition for judicial review was dismissed by Superior Court Judge Gregory on Nov. 18, 2020. Aetna has since appealed that ruling. NCDHHS will continue its work to prepare for the launch of Medicaid Managed Care on July 1, 2021.

North Carolina’s approach to managed care has received national recognition and focuses on improving the health of North Carolinians through an innovative, whole-person centered and well-coordinated system of care that addresses both the medical and non-medical drivers of health. Open enrollment for Medicaid Managed Care begins March 15, 2021.

For more information on NC Medicaid's transformation to Medicaid Managed Care, go to www.medicaid.ncdhhs.gov/transformation.

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