November 2, 2020
Medicaid is a program jointly administered by the federal and state governments, with each state administering its own Medicaid program under federal rules. Managed care, a foundational building block of North Carolina’s Medicaid Transformation, is an authorized Medicaid delivery model under Section 1932 of the Social Security Act and allows for the state to delegate the administration of Medicaid to private insurance companies. Federal regulations that implement Section 1932 define state and federal oversight responsibilities in detail.
While the Act and regulations establish federal minimum requirements, states have considerable flexibility in program implementation. Understanding Medicaid regulations is critical to not only understanding how the program will work in North Carolina but, perhaps even more importantly, to understanding the full context of the State’s Medicaid 1115 Transformation Waiver and the N.C. Department of Health and Human Services’ strategy for the delivery of value-based care generally.
In this 90-minute webinar, we educate participants on the joint administration of Medicaid and the relationship between federal and state oversight; Federal statutory and regulatory Medicaid managed care requirements; how North Carolina intends to operationalize these requirements under a managed Medicaid program and its 1115 Medicaid Transformation Waiver; and, steps that providers and other stakeholders can take to prepare for Medicaid Transformation, which was set to go-live on July 1, 2021.