RALEIGH — The Department of Health and Human Services announced Tuesday, Sept. 3, that it will extend open enrollment for Medicaid beneficiaries to Dec. 13 and move to a statewide transition to managed care on Feb. 1, 2020.
According to a release from DHHS, managed care in North Carolina was scheduled to roll out in two phases, with Medicaid beneficiaries in part of the state beginning managed care services on Nov. 1 and most of the state beginning on Feb. 1, 2020. With the announcement on Sept. 3, managed care will now go live in one phase for the whole state beginning on Feb. 1, 2020.
The timeline has been adjusted because DHHS cannot implement critical actions to go live with managed care under the current continuing resolution budget, according to the release. The updated timeline only impacts counties that were in Phase One, which includes Ashe County.
The next set of activities that must be implemented depend upon budget action, including finalizing the rates to pay health plans and providers, ensuring health plans have enough providers in their networks to meet the needs of beneficiaries, deploying a complex algorithm to assign beneficiaries who do not self-select plans and doctors and obtaining federal approval to launch, the release said.
Since July, DHHS has advised its partners and the North Carolina General Assembly that the timing of the budget would impact the state’s schedule for moving to managed care, the release said.
According to the release, ongoing budget uncertainty has been an impediment to health plans finalizing contracts with doctors and health providers.
Open enrollment will be extended from its original deadline of Sept. 13 for 27 counties to Dec. 13. Nothing changes for the remaining 73 counties. As planned, open enrollment will begin for those 73 counties on Oct. 14 and run through Dec. 13.
The 27 counties where open enrollment will be extended are Alamance, Alleghany, Ashe, Caswell, Chatham, Durham, Davidson, Davie, Forsyth, Franklin, Granville, Guilford, Johnston, Nash, Orange, Person, Randolph, Rockingham, Stokes, Surry, Vance, Wake, Warren, Watauga, Wilkes, Wilson and Yadkin counties.
For more information about how to enroll, visit ncmedicaidplans.gov or call 1 (833) 870-5500.