DHHS Awards Contract for Medicaid Managed Care Enrollment Broker Services to MAXIMUS | Eastern North Carolina Now

Press Release:

    RALEIGH - The North Carolina Department of Health and Human Services today announced that it has awarded its contract for Medicaid managed care enrollment broker services to MAXIMUS, a government services provider based in Reston, Va. This is the first procurement contract award as the state prepares to move toward Medicaid managed care in North Carolina, a major milestone in the Medicaid transformation process.

    Under managed care, which is expected to take effect in 2019, MAXIMUS will provide choice counseling, enrollment assistance and education to beneficiaries as they select from a variety of health plans. As part of the enrollment broker function, MAXIMUS will help members select the health plan and primary care provider that is most appropriate to meet their needs and, to the extent possible, maintain existing physician-patient relationships. MAXIMUS staff will be available to help members enroll over the phone via a call center, online through an interactive and user-friendly website and face-to-face in some communities.

    To help ensure a seamless and streamlined beneficiary experience, MAXIMUS will establish an ongoing partnership with the state's 100 county departments of social services and provide dedicated liaisons who will work closely with caseworkers and other county staff to provide managed care training, make beneficiary materials available locally and conduct outreach services.

    The estimated cost of the contract is $17 million, but the actual cost will depend on the number of beneficiaries eligible for managed care enrollment and whether DHHS engages any optional services under the contract.

    As North Carolina transitions to managed care, DHHS is committed to improving the health and well-being of North Carolinians through an innovative, whole-person centered and well-coordinated system of care that addresses both medical and non-medical drivers of health. The selection of an enrollment broker will help advance that goal while ensuring Medicaid beneficiaries have the support they need to select the health plan that is right for them or their family.

    "Selecting an enrollment broker is an important milestone as we build a new system of managed care and move toward our vision of an NC Medicaid program that optimizes health and well-being for all," said DHHS Secretary Mandy Cohen, M.D.

    The department originally issued the request for proposal for independent enrollment broker services in early March and selected MAXIMUS from a pool of applicants based on a careful evaluation of the proposals submitted.

    For additional information on the department's Medicaid transformation effort, visit https://www.ncdhhs.gov/medicaid-transformation.

      NC Department of Health and Human Services

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