The Council has been following the transition to managed care since 2015 when the NC General Assembly enacted legislation directing DHHS to transition Medicaid and NC Health Choice from fee-for-service to managed care. Since that time, the Department of Health and Human Services has worked to design the Standard Plan and Tailored Plan and identified the Prepaid Health Plans who would manage the Standard Plan which was planned to begin February 1, 2020. There was an expectation that required funding and program authority would be provided through the legislative budget process. Without the needed action by the General Assembly, DHHS has suspended the transition process. This means there will be no changes to the current system in February and individuals will continue to receive their healthcare under the current fee-for-service system.
This is a suspension and not a cancellation of the plan. DHHS has indicated that a new timeline will be developed once the required legislative action occurs.
To find out more information on the NC Medicaid Transformation, read the Public Policy Updates.