As we prepare for the North Carolina Department of Health and Human Services' upcoming Medicaid…
LME/MCOs Move Forward with State-Directed Medicaid Rate Reductions Effective November 1
Beginning November 1, 2025, all four LME/MCOs operating Tailored Plans will implement the Medicaid rate reductions directed by the North Carolina Department of Health and Human Services (NCDHHS), effective October 1, 2025.
The LME/MCOs delayed implementation by one month to minimize provider disruption and allow time to identify a possible resolution. Unfortunately, no solution has been reached, and the LME/MCOs must now proceed with implementation of the rate reductions.
We understand these reductions are significant and will have serious consequences for North Carolina Medicaid providers. While all four LME/MCOs will begin applying reduced rates on November 1, the processes for recouping October payments made at the previous higher rate may vary by organization. Providers should closely review communications from each LME/MCO for specific details and timelines.
The NC Association of Public Community Health Plans continues to advocate with the North Carolina General Assembly and the Governor's Office to reverse these cuts as soon as possible. We remain committed to open communication and to working alongside our provider and community partners to preserve the strength and stability of North Carolina's public behavioral health system.
NCAPCHP Letter to Provider Associations - Implementation of State-Directed Medicaid Rate Reductions
