On September 29 North Carolina Medicaid announced it will delay the launch of the Behavioral Health Intellectual/Developmental Disability Tailored Plans from December 1 until April 1.
This decision was made with support of the managed care organizations to ensure beneficiaries can seamlessly receive care on day one.
Just as Medicaid members and state-funded recipients do today, they will continue to receive serious behavioral health services, I/DD services, and Traumatic Brain Injury support through Trillium.
Members will continue to receive physical health and pharmacy services through NC Medicaid Direct until April 1.
Trillium continues to contract with providers, complete necessary staff training, and meet requirements for readiness during this time. The company will share more information in the weeks to come on any changes this delay may prompt.
“Trillium and our standard plan partner, Carolina Complete Health, have been adding more providers so our members can continue to see the health care professionals and use the health care facilities as they have been today,” said Joy Futrell, Trillium’s CEO. “These extra few months will allow more time to help us meet continuity of care for everyone we serve.”
There are two exceptions to this delay:
Tailored care management will start for eligible Medicaid members on December 1.
The new 1915(i) services will go live on December 1 as well, pending approval by the Centers for Medicare and Medicaid Services.
North Carolina Medicaid and MCOs will support providers of tailored care management to launch their services on December 1.
Through tailored care management, eligible beneficiaries will have a single designated care manager supported by a multidisciplinary team to provide integrated care management that addresses the beneficiary’s whole-person health needs.
Information regarding TCM will be sent to eligible members soon.
Medicaid will also launch the new 1915(i) option, to help beneficiaries remain in their homes and community-based settings.
Services available will include:
Respite
Individual and transitional supports
Community Living and Supports
Community transition
Supported employment
North Carolina Medicaid will announce a new choice period for members to select a primary care provider in 2023.
If any members have already selected their PCP, their choice will be kept.
Welcome packets for members and recipients to include handbooks, letters, and Medicaid ID cards will be sent out next year.
Tailored plans will serve individuals with significant behavioral health needs and I/DDs, as well as other populations, including Innovations Waiver and TBI members, and waitlist members. Tailored plans are also responsible for managing the state’s non-Medicaid behavioral health, developmental disabilities and TBI services for uninsured and underinsured recipients.
Certain services, such as mobile crisis, will be available to all populations, regardless of insurance.
