Monday, 24 January 2022 19:28

NC Medicaid Managed Care contract award appeals dismissed

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RALEIGH — On Jan. 19, 2022, the North Carolina Court of Appeals granted a request from two insurance providers to voluntarily dismiss appeals of their suit over contracts awarded for NC Medicaid Managed Care by the North Carolina Department of Health and Human Services.


My Health by Health Providers and Aetna previously filed suit over the contracts awarded to AmeriHealth Caritas North Carolina Inc., Healthy Blue of North Carolina, UnitedHealthcare of North Carolina Inc., WellCare of North Carolina Inc. and Carolina Complete Health Inc. in 2019. In February 2021, a Superior Court judge found NCDHHS acted correctly, and the two insurance providers filed the appeal that was withdrawn last week.

“We are pleased at this outcome and believe it affirms the integrity and fairness of the department’s procurement process,” said Deputy Secretary for NC Medicaid Dave Richard, “We look forward to continuing our focus on delivering innovative and whole-person care to North Carolinians through Medicaid Managed Care.”

NCDHHS launched NC Medicaid Managed Care on July 1, 2021, which currently covers 1.7 million North Carolinians. NCDHHS has leveraged the move to managed care to build a health care delivery system that puts the health of beneficiaries at the forefront.

North Carolina’s approach to managed care has received national recognition and focuses on improving the health of North Carolinians through an innovative, whole-person centered and well-coordinated system of care that addresses both the medical and non-medical drivers of health.

Features of the state’s program also include establishing a payment structure that rewards better health outcomes, integrating physical and behavioral health, helping people manage their care through care management and implementing a quality strategy to promote health plan accountability.

For more information on NC Medicaid Managed Care, go to https://medicaid.ncdhhs.gov/transformation.