When are Tailored Plan changes happening?

To ensure beneficiaries can seamlessly receive care on day one, the North Carolina Department of Health and Human Services (NCDHHS) is delaying the implementation of the NC Medicaid Managed Care Behavioral Health and Intellectual/ Developmental Disabilities Tailored Plans (Tailored Plans) scheduled for Oct. 1, 2023, but will now go forward at a date still to be determined.

Beneficiaries who will be covered by the Tailored Plans will continue to receive behavioral health, I/DD, TBI and physical health care as they do today. North Carolina’s unique Tailored Care Management model, which launched Dec. 1, 2022, will continue to support beneficiaries by providing a care team to coordinate care across providers. Additionally, on July 1, 2023, the LME/MCOs began to provide 1915(i) services to offer an array of home and community based (HCBS) services to Medicaid beneficiaries with serious mental health diagnoses, severe substance use disorders, intellectual/developmental disabilities and traumatic brain injuries.

For more information about Tailored Plans, visit NC Medicaid’s Tailored Plan website. For more information about 1915(i) services, visit NC Medicaid’s recent provider bulletin.