2005 NC Legislation Impacting HC/NCHC

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(11/05) -- Effective January 1, 2006, there will be changes in Health Check (Medicaid) and NC Health Choice that affect eligibility and coverage for children birth through 5 years. On this date:

• Eligibility for Health Check for children birth through 5 years of age will change to 200% of the federal poverty level (currently $38,700 for a family of 4).
  
• Children birth through 5 enrolled in NC Health Choice will be moved to the Health Check Program. (See additional articles in "News" for details regarding transition implementation).
  
• Health Choice will cover children ages 6 through 18 at the same eligibility levels as before (family incomes between 100% and 200% of the federal poverty level). No children ages birth through 5 will be covered under NCHC after January 1, 2006.

Effective January 1, 2006, the Department of Health and Human Services may allow up to 3% enrollment growth in the NC Health Choice Program every 6 months. (Our current rate of growth is around 0.5% per month).

On January 1, 2006, NC Health Choice reimbursement rates will be paid at 115% of the Medicaid fee schedule; effective July 1, 2006, the rates will be paid at 100% of the Medicaid fee schedule. Blue Cross/Blue Shield of North Carolina will continue to be the intermediary for processing NC Health Choice claims.

Also, the Department of Health and Human Services will be moving NC Health Choice children ages 6 through 18 into the Community Care of NC (CCNC) networks for case management, and NC Health Choice will pay CCNC providers for these services as is currently allowed under Medicaid. (Details about implementation of this provision will be shared when available).