Medicaid Reform Minute #6: Patients outside of Standard Plans1
Patients in Special Populations will remain in fee-for-service until they are phased in to Managed Care at a later date.
Exempt patients may choose to join a PHP but are not required. Excluded patients will remain in fee-for-service Medicaid.
1Standard plans are outlined here: https://files.nc.gov/ncdhhs/documents/files/PopulationProfiles.pdf?oI2oB1itRV6ozGxXBzNkaPZPK1zG3jgx
2Details on the Tailored Plan are outlined here: https://medicaid.ncdhhs.gov/behavioral-health-idd-tailored-plans
3More details pending
4Per source link, “Beneficiaries who are dually eligible for Medicare and Medicaid are currently excluded. The Department is contemplating phasing in dually eligible members to managed care, pending additional authority from the General Assembly.”
This Medicaid Reform Minute is provided courtesy of a partnership between Community Care of Western North Carolina and the Western Carolina Medical Society. For questions about this content, contact firstname.lastname@example.org.