Archive | NC Medicaid

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NCAFP Past President Dr. Shannon Dowler Named Medicaid’s New Chief Medical Officer

Academy Past President Shannon Dowler, MD (’13) has been named the new incoming Chief Medical Officer for the North Carolina Division of Health Benefits/North Carolina Medicaid. Dr. Dowler has a long history of service in leadership roles in North Carolina. Professionally, she most recently served as the Chief of Community Medicine and Ambulatory Population Health […]

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Several Medicaid Managed Care Meet-and-Greets are Planned Through End of June

DHHS has several regional sessions scheduled through the end of June 2019 that will offer providers an opportunity to meet with representatives of Medicaid managed care health plans. The sessions provide the chance to ask Medicaid subject matter experts specific questions about provider network participation, the Medicaid managed care transition, and more. For a complete […]

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DHHS Issues Policy Paper Describing How CINs will Assist Advanced Medical Homes

A new policy paper released by NC DHHS describes how clinically-integrated networks (CINs) can help Advanced Medical Homes (AMHs) meet the care coordination and management requirements as listed in the Preferred Health Plans RFP and the AMH Provider Manual. The paper describes methods for increasing administrative efficiencies in these activities, while elaborating on the roles […]

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Provider Transition to Medicaid Managed Care: New Webinar Series Will Launch March 28th

NC Medicaid will launch a webinar series to support providers and practices during their transition to NC Medicaid Managed Care. “General” webinars are overviews of significant changes and features of the managed care program. “Topical” webinars are in-depth reviews of specific managed care topics. The first webinar in this series, Provider Transition to NC Medicaid […]

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Tool Available to Help Practices Examine Medicaid Manage Care Contracts

The NCAFP, in collaboration with Health Management Associates and the AAFP, has developed a two-page checklist of things to consider and questions to ask before contracting with one of the state’s recently-named Medicaid Managed Care organizations. While the document does not substitute for legal advice — and practices should seek legal guidance before signing a […]

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State Announces Prepaid Health Plan Contracts for Medicaid Managed Care

The NC Department of Health and Human Services announced the selection of Prepaid Health Plans on February 4th that will participate in Medicaid Managed Care when the program launches in November 2019. Statewide contracts were awarded to AmeriHealth Caritas North Carolina, Inc.; Blue Cross and Blue Shield of North Carolina; UnitedHealthcare of North Carolina, Inc; […]

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Physicians Can Look to CCNC/CCPN for Help in Achieving Advanced Medical Home Tier 3 Status

Under North Carolina’s Medicaid Transformation plan, practices attesting as Tier 3 Advanced Medical Homes (AMHs) can receive care management revenue and value-based payments from health plans for meeting quality targets. Irrespective of your practice type (system-based or independent), practices need to reach five categories of requirements to attest as Tier 3. Without the right partner, […]

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