Vaya Health and Cardinal Innovations, two of North Carolina's largest managed care organizations announced last week that they will consolidate in preparation for the state’s transformation to Medicaid managed care.
While there are a number of details still to be finalized, the North Carolina Department of Health and Human Services (NCDHHS) wants to update you of the following:
Beneficiaries will continue to receive their services and supports. Medicaid In lieu of services and DMH alternative services currently in place will continue to be provided and we anticipate those services will be approved to be available in the entire new Vaya catchment area.
Providers will not see any changes to their rates during this transition and all providers in good standing currently in network will continue to be in network in the consolidated entity.
The counties that have been approved to disengage will continue in that process. Counties that have voted to disengage will have their request reviewed in accordance with the disengagement rules. Any other county served by Cardinal that would request disengagement in light of the consolidation announcement may do so. Vaya is already planning immediate outreach activities to counties in the Cardinal catchment area, though counties are welcome to have conversations with other LME-MCOs. We ask counties that these conversations happen rapidly.
DHHS will work closely with the leadership of each organization to execute this consolidation. Although the final consolidation may take up to a year, the transition to Vaya oversight will happen over a shorter period. We will continue to keep you informed about the progress of the consolidation during the weeks and months to come. Vaya and Cardinal are also committed to providing information and communication rapidly and consistently.
Below is a statement that NCDHHS provided to the press in response to inquiries about the consolidation.
“DHHS has been actively engaged to ensure the thousands of consumers currently served by Cardinal Innovations continue to receive needed supports and services. The decision of Mecklenburg County to vote to request disengagement from Cardinal Innovations and the recent vote by Forsyth County to disengage from Cardinal introduced uncertainty and instability for the Cardinal organization and those they serve. We appreciate the boards of Vaya and Cardinal working rapidly to reach an agreement to consolidate to provide stability for beneficiaries and families. We will work closely with the boards and staff of each organization to better understand and work through the details of this transition.
There is still much work to be done. DHHS will continue to work with the counties who have requested disengagement and work with the NCACC to determine if additional counties are considering disengagement and the best process for moving forward. Throughout the process we will actively engage consumers, families, and providers for input."
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