NC Medicaid Direct was formerly known as fee-for-service. Some people will remain in NC Medicaid Direct because it provides services that meet specific needs.
NC Medicaid Direct is North Carolina’s health care program for Medicaid beneficiaries who are not enrolled in health plans. It includes care management by Community Care or North Carolina (CCNC), the primary care case management entity (PCCMe) for physical health services. Six Local Management Entity-Managed Care Organizations (LME-MCOs) coordinate services for mental health disorder, substance use disorder, intellectual/developmental (I/DD) or traumatic brain injury (TBI). Some people are enrolled in NC Medicaid Direct because it provides services that meet specific needs.
These populations include:
* People who receive both Medicare and Medicaid
* People who are medically needy
* People in the NC Health Insurance Premium Payment (HIPP) Program
* Children who receive Community Alternatives Program for Children (CAP/C) services
* People who receive Community Alternatives Program for Disabled Adults (CAP/DA) services
* Children and youth in foster care