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Tailored Care Management – Draft Provider Manual

NC Medicaid is pleased to share for comment the draft provider manual and application process for care management for people with behavioral health and intellectual and development disabilities who will be served by Tailored Plans. While the implementation of managed care has been suspended as legislative action is needed to move forward, NC Medicaid continues to work on the design of Tailored Plans.

One of NC Medicaid’s key areas of focus in Medicaid Transformation is building robust and effective models for managing beneficiaries’ comprehensive needs through local care management. Provider-based care management will promote whole-person care, foster high-functioning integrated care teams, and drive towards better health outcomes.

NC Medicaid recognizes that it will take time to build up a delivery system to support Tailored Care Management that is fully integrated with primary care and other providers. This manual supports providers by describing the model requirements and initiating the certification application process for AMH+s and CMAs. As described in the manual, there will be a schedule for reviewing applications throughout 2020 in four “batches.” The first deadline for providers to apply will be February 7, 2020.

Please share your comments on the manual with Kelsi A. Knick at by January 2, 2020.

NC Medicaid will host a webinar for providers entitled “Tailored Care Management: What Providers Need to Know”, on December 18, 2019, from 11:30 am–12:30 pm. This webinar will explore the provider manual in more detail, walk through the application process, and address questions for you to consider. You may register for the webinar here.

For now, North Carolina’s move to Medicaid Managed Care has been suspended. All health providers enrolled in Medicaid are still part of the program and will continue to submit claims through NCTracks as they do today. Beneficiaries will continue to access behavioral health and I/DD services through LME-MCOs. These services will continue to be provided as they are today.


North Carolina Assisted Living Association


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