State health officials are taking another step toward reform of the N.C. Medicaid program, this time addressing requirements for physical managed care organizations.
In September 2015, the Republican-controlled legislature approved shifting Medicaid from a fee-for-service structure to a managed care structure.
The current Medicaid waiver request to federal health regulators proposes a hybrid public and private sector reform solution that eventually would combine physical and behavioral health into a whole-body care platform.
The N.C. Department of Health and Human Services projects about $400 million in savings in the first five years of implementation.
Last week, DHHS released two requests for information. One addresses physical MCOs, including a statement of interest from prospective prepaid health plans. The deadline for responses is 2 p.m. Nov. 22. The other focuses on the financial aspects of managed care, including information on the proposed capitation rate setting methodology. The deadline for responses is 2 p.m. Dec. 1.
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