NC Managed Medicaid Starts July 1, 2021
As you’ve likely heard, North Carolina Medicaid is shifting to Managed Medicaid starting July 1, 2021, and, as your partner in mobility, National Seating & Mobility is here to ensure your patients’ continue to get the independence and support they deserve.
NSM has been communicating with Medicaid and the commercial carriers who will be managing the Medicaid coverage regularly so we can anticipate and have a plan to mitigate gaps of care and ensure timely provision of your patients’ mobility devices and adaptive aids.
What you should know about wheelchair and adaptive aids provision during this change:
NSM has your patients covered! NSM is in network with all of the health plans that will be managing North Carolina’s Medicaid program, except the Tribal Option.
Beneficiaries will have six health care options to choose from when they enroll, based on the region in which they live:
- UnitedHealthcare Community Plan
- Healthy Blue
- AmeriHealth Caritas
- Carolina Complete Health*
- EBCI Tribal Option**
Open enrollment was May 14th- May 21st to select a plan. If a plan was not selected, your patient will be auto enrolled into a plan based on available plan options in their county.
What to expect:
May 22, 2021 (approximate) – Transition of Care information is sent to each Health Plan for beneficiaries assigned to that Health Plan this will include last 2 years of history on client and authorization on file (will be able to see what health plan client move to in NC Tracks)
July 1, 2021 – Medicaid Managed Care launch
Who does not need to select an MCO plan?
Some people will not need to choose a health plan because of the type of health services they need. They will stay enrolled in NC Medicaid Direct. For example, individuals who get Innovations Waiver services, Traumatic Brain Injury (TBI) Waiver services, or Community Alternatives Program for Children (CAP/C) or Community Alternative Program for Disabled Adults (CAP/DA) services will stay enrolled in NC Medicaid Direct. If you qualify, you can choose the EBCI Tribal Option and keep getting waiver services.
Beneficiaries have 90 days after the effective date of initial enrollment to change their Health Plan or PCP for any reason.
Members of federally recognized tribes
- Beneficiaries dually eligible for Medicaid and Medicare
- Program of all-inclusive care for the elderly (PACE) beneficiaries
- Medically needy beneficiaries
- Beneficiaries eligible for only emergency services
- Presumptively eligible enrollees during the period of presumptive eligibility
- Health insurance premium payment (HIPP) beneficiaries
- Family planning beneficiaries
- Prison inmates
Keeping Your Clients Moving with Lifts
We believe everyone should have access to life. That's why we offer a wide array of lifts designed to keep you independent at home and beyond.
It’s your home; you should be able to easily access and enjoy every room in it, including the upper level. NSM provides stair lifts that can be fitted to any existing staircase so you can move up and down your stairs with ease. Each of our indoor and outdoor stair lifts are compact, ergonomically designed and made to last.
Just going to need it for a little while? No problem! We offer temporary stair lift rentals as well as installation and repair.
In-home lifts allow you to more easily accomplish day-to-day tasks like transferring from bed to a mobility device especially where space is limited, so you can move around your home more freely without worrying about risking injury. From freestanding to mounted lifts, portable units to slings, NSM lifts can help you live independently every day.
We believe mobility challenges shouldn’t keep anyone from enjoying the world beyond their front doors. Vehicle lifts allow mobility device users to fully experience life the way they want by empowering them to go wherever the road may be calling them. No matter the vehicle, NSM offers powerful lifts ranging from economical to high-tech options to suit each person’s needs.
NSM is excited to bring you a day full of industry experts sharing the latest in mobility innovation and therapeutic best practices. NSM Cares Symposium will take place on October 20, 2021 EST at SMS Catering in Charlotte, NC. This event will provide attendees 6 CEU hours.
- 8:00- Registration & Continental Breakfast
- 8:30-10:30-Optimizing a Wheelchair – Taking Advantage of the Technology to Get the Best Outcomes, Now and In the Future-Curt Prewitt MS,PT, ATP - Director of Education- Ki Mobility
- 10:30-11:00- Vendor spotlights
- 11:00-12:00- A Case for Excellence-Manual (.1 CEU, 1 contact hours)-Jennith Bernstein PT,DPT, ATP/SMS- Regional Clinical Education Manager- Permobil
- 12:00-1:00- Lunch provided by NSM, Vendor spotlights
- 1:00-2:00- A Case for Excellence- Power (.1 CEU, 1 contact hours)-Jennith Bernstein PT,DPT, ATP/SMS- Regional Clinical Education Manager- Permobil
- 2:00-2:30- Vendor spotlights
- 2:30-4:30-Clinically Speaking – A Practical Guide to Evaluation and Documentation for Power Seating Options (.2 CEU, 2 contact hours)- Jay Doherty OTR, ATP/SMS- Director of Clinical Education- Quantum Rehab
Special thanks to our sponsors:
Sleep Safe Beds
Logantech Speech Devices
Tabatha James, OTR/L, ATP is a new member of the National Seating & Mobility team for North Carolina. She is an alumna of the University of Illinois Chicago’s Occupational Therapy program, RESNA certified ATP and is member of AOTA and the Clinician Task Force. Tabatha has robust experience as a seating and mobility clinician servicing adults and children with neurological disorders in and around the Chicagoland area. She now lives in North Carolina and is eager to make an impact in our local communities as a holistic seating and mobility specialist.
Tabatha is passionate and intentional about appropriate CRT/DME prescription and presumes competence in her clients across the spectrum of age and ability. She has worked in home health, subacute rehabilitation, in the public school system, and as a hippotherapy provider. Additionally, Tabatha is involved in educational and advocacy efforts for the seating and mobility industry, focusing on equitable distribution and access to health care for persons with disabilities.
To staff a client or scenario with Tabatha, or discuss clinical benefits of seating and mobility equipment call 828.489.9389, or email Tabatha.James@NSM-Seating.com.
Tabatha has joined our Charlotte Branch but will be joining the Winston/Salem location when it opens in the coming months.
Your NSM Team Supporting North Carolina and South Carolina:
Call your closest branch to start the process for new home modifications, adaptive aids or mobility device.
Asheville - 828.277.2577
- Dennis May, ATP
- James Drechsel, ATP
- Jim Parnell, ATP
- Mike Edney, ATP
Charlotte - 704.333.8431
- Alex Claywell, ATP
- Amy Eby, COTA, ATP
- Tabatha James, OTR/L, ATP
- Joshua Cowles, RTS
- Robert Flanagan, ATP
Greensboro/Winston Salem - Coming Soon!
Raleigh - 984.232.6471
- Doug Walter, ATP
- Gordon White, ATP
- Jeff Tutor, ATP
- Travis Stephens, ATP
Charleston - 843.737.5756
- David Kascak, ATP
- Jim Spencer, ATP
Columbia - 803.799.1133
- Archie McPherson, ATP
- Steven Still, ATP
- Steven Ward, ATP
Greenville - 877.924.2477
- David Adcox, ATP
- Jeff Hennessee, ATP