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By Rose Hoban

The next step in North Carolina’s Medicaid reform process requires state health officials to prepare an application that will go to federal regulators at the Centers for Medicare and Medicaid Services.

Since CMS pays for two-thirds of North Carolina’s Medicaid program, federal regulators have the power to greenlight any plans for changes.

North Carolina is asking for a so-called 1115 waiver to the federal Social Security Act. 1115 waivers are supposed to not just save money but also demonstrate that the state is engaging in innovative ways to deliver care to Medicaid recipients: children, some of their parents, pregnant women, people with disabilities and low-income elderly. The waiver applications are also supposed to show how, in exchange for being exempt from some federal rules, North Carolina can strengthen its Medicaid program, improve health outcomes for beneficiaries and strengthen the networks of providers who care for Medicaid recipients.

People who are interested can also take a look at the draft proposal, which details how North Carolina plans to ask CMS to waive some of the standard federal rules.

Part of the requirements for making Medicaid changes is giving the public a chance to weigh in at public hearings, which were announced this week by North Carolina’s Department of Health and Human Services. Twelve hearings will be held around the state, starting March 30 in Raleigh and wrapping up on April 18 in Pembroke.


Click on the purple tag nearest you to find out when there’s a hearing.

For people who cannot make it to one of the hearings, written comments can be made to:
email: MedicaidReform@dhhs.nc.gov

U.S. Mail: Division of Health Benefits
North Carolina Department of Health and Human Services
2501 Mail Service Center
Raleigh, NC 27699-2501

In person: North Carolina Department of Health and Human Services
101 Blair Drive
Adams Building
Raleigh, N.C.

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