NC again delays tailored plan for Medicaid enrollees with mental health, developmental disabilities

North Carolina health officials have again delayed the start of a managed care program for Medicaid enrollees specifically who also receive services for behavioral health needs or intellectual or development disabilities.

The state Department of Health and Human Services announced on Monday that it would push back the most recent start date for these managed care “tailored plans” for nearly 150,000 people from April 1 to Oct. 1.

The original start date had been this past Dec. 1, but DHHS said in the fall that the regional behavioral health organizations that would coordinate and manage all of the care needed more time to contract with service providers and to ensure data systems worked properly.

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DHHS again mentioned on Monday the need for additional providers “to ensure a smooth transition for people using the plans and their care providers.”

In July 2021, the state moved two-thirds of North Carolina’s then-2.5 million Medicaid recipients from a traditional fee-for-service system to one in which several statewide health plans and one multiregional plan received monthly payments for each patient they enrolled and treated.

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This change, however, was delayed for consumers with developmental disabilities, substance abuse needs and severe mental health troubles while the tailored plans, which will provide conventional medical care and other specialized services, were created.

The regional behavioral health organizations have been in place for years and are separate from the other managed care plans. For now, people to be covered by the tailored plans will continue receiving care through their existing plans, DHHS said.

The tailored plans also will oversee assistance for people with traumatic brain injuries and manage non-Medicaid services for these populations.