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Expanded Medicaid managed care for people with mental illness or disabilities to begin July 1


by Lynn Bonner, NC Newsline
February 6, 2024

New managed care plans for North Carolinians whose mental health treatment or disability care is coordinated and paid through regional mental health offices will launch on July 1.

Under these “tailored plans,” regional mental health offices called “Local Management Entities/Managed Care Organizations” will pay for health care for people with mental illnesses, developmental disabilities, substance use disorder, or traumatic brain injury.  

The launch of the tailored plans comes after several delays and reluctance on the part of medical systems to sign network contracts.

For years, the LME/MCOs have used state and federal money to purchase mental health care and disability services for people who use Medicaid. 

Under the tailored plans, beneficiaries will also receive health care and medications through their LMEs. These beneficiaries have been receiving fee-for-service medical care. 

The new launch date comes after a major consolidation in which the number of LMEs shrank from six to four. Trillium Health Resources expanded this year to cover 46 counties. 

The state Department of Health and Human Services estimated last year that the tailored plans will cover 160,000 beneficiaries. 

Beneficiaries will receive information packets that will include the name of their primary care provider in late May, Kelly Crosbie, director of the mental health, developmental disabilities and substance use services division, said during a webinar Monday. The packet will include information on how beneficiaries can pick a new primary care provider.

Managed care for most Medicaid beneficiaries’ physical health care started in July 2021.

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