North Carolina
Providers key in NC’s push to launch delayed Medicaid plans for complex populations
After multiple delays, the North Carolina Department of Health and Human Services says it’s “on track” to implement specialized Medicaid plans this summer that are designed for beneficiaries with complex needs.
Now scheduled to launch on July 1, the so-called “tailored plans” are expected to cover about 150,000 existing Medicaid participants who require more extensive care and support than typical enrollees. Many people with intellectual or developmental disabilities, traumatic brain injuries, complex psychiatric disorders and substance use disorders will be moved to the plans, according to DHHS.
Unlike standard Medicaid plans, the tailored plans will be administered by a network of four state-funded behavioral health organizations, or LME-MCOs. For the past decade, these regional managed care organizations have been providing access to behavioral health services for people with complex needs across the state, sometimes operating under a cloud of controversy.
Now, they have been tasked with connecting tailored plan participants to physical and mental health care providers.
The tailored plans were initially scheduled to go live in December 2022, but DHHS delayed the launch to give the LME-MCOs more time to prepare. Additional delays were announced last year, with the department citing a lack of buy-in among some providers.
Jay Ludlam, the state’s deputy secretary for Medicaid, gave lawmakers an update on the plans’ status as part of Tuesday’s meeting of the Joint Legislative Oversight Committee on Medicaid. The LME-MCOs, he said, have “made significant progress in closing any remaining gaps in their networks.”
Push for more providers
Ludlam told the committee that DHHS established an internal “disruption standard” after the most recent delay. The department’s goal was to ensure that at least 80 % of tailored plan participants would “not be disrupted in their current relationships” with providers.
“Our focus has been on those families that […] have worked with certain care teams for years, often since birth, to provide care to their loved ones,” Ludlam said. “We also saw pressures from others who wanted, as much as possible, to ensure that we as a department recognize that it’s not only just the provision of services, [but] also who’s providing those services … that is important to those families.”
He said that federal regulators were OK with the 80% goal last spring, but they want at least 90% of the state’s tailored plan participants to have the option of staying with their current provider in order for the plans to launch this July.
That rankled committee member Sen. Ralph Hise (R-Spruce Pine), even though he’s long been critical of the LME-MCOs.
Hise said he was concerned that the higher standard required by the Centers for Medicare and Medicaid Services would force the LME-MCOs to “sign contracts that might not be in the best interest of their system.” Some providers, he said, were already dissatisfied with the reimbursement rates that the LME-MCOs were offering for services.
“Then CMS kind of steps in and says, ‘First of all, you have to have 80 [%] and now you have to have 90 [%],’ and suddenly these contracts are getting signed,” Hise said. “I mean, somebody stuck their nose in a contract dispute, told them who they had to sign with and, in effect, what rates they had to sign for.”
Ludlam responded by pointing out that the issues with provider contracting “are sometimes not about money.”
“They’re about how many lives the tailored plans were managing, and that it wasn’t sufficient for the systems to basically bother to pick up the pen and sign those contracts,” he said. “By focusing on what the members need, and of course monitoring the potential impact on rates, I do believe that we will not only protect people through this process, but that we will be able to get to go live on July 1.”
One factor in creating a Medicaid plan is the quest for “network adequacy” — the ability for a patient to find the care they want and need close to home. This means the plans’ managers have to contract with hundreds, sometimes thousands of health care providers throughout a region.
Ludlam noted that two of the state’s LME-MCOs recently contracted with a “large system” to accept tailored plans. Ludlam declined to share the system’s name, but Charlotte-based Atrium Health had previously been identified as a significant holdout in the state’s push to enlist providers. A spokesperson for Atrium did not immediately respond to email from NC Health News on Wednesday.
Ludlam said DHHS has not “re-measured” the potential disruption of existing patient-provider relationships since the unnamed system came aboard.
“If I were to highlight any potential risk to go live, it is whether or not the tailored plans will be able to close out some of those other contracts that are going to be necessary to minimize the disruption for consumers and members,” Ludlam said.
He added that DHHS will make a “go or no-go decision” in April on the July 1 rollout date if the LME-MCOs have not contracted enough providers to satisfy CMS’ requirement by then.
“If we really saw a high risk of potential member harm for individuals, we would do what is necessary to protect people,” Ludlam said of the possibility of another delay. “We would want to work very closely with CMS to make sure that if they’re declaring that we’re unable to go live, that they’re doing it based on the best available data and for all the right reasons.”
Rollout riding on LME-MCOs
Ludlam said the burden of contracting enough providers to maintain continuity of care for tailored plan patients will largely fall on the LME-MCOs. They know the “individuals who might be at risk” and “where they are,” he said.
“The work is going to be on them,” he said. “I think generally they are very close to getting contracts with these care teams, and we will continue to monitor it over the next couple of months.”
The implementation of tailored plans will follow a consolidation that left the state with four LME-MCOs instead of its previous six. Sec. Kody Kinsley, head of DHHS, ordered the consolidation in November to streamline the plans’ rollout.
Trillium Health Resources took control of Eastpointe Human Services under the consolidation, creating a single organization to serve 46 counties across eastern North Carolina. Another LME-MCO, the Sandhills Center, was dissolved in connection with the consolidation.
The remaining organizations include Vaya Health, which serves most of the western part of the state, and Alliance Health and Partners Health Management, which together cover a mosaic of counties in central North Carolina.
Ludlam said his “Day One goals” for tailored plans are to “make sure that members have cards in hand, that the health plans have sufficient networks, that providers can get paid and that members can have access to those health plans in order to understand their benefit, understand who they’ve been assigned to and make sure that they can get care.”
This article first appeared on North Carolina Health News and is republished here under a Creative Commons license.
The NC Lottery offers several draw games for those aiming to win big.
Here’s a look at Saturday, June 27, 2026 results for each game:
Winning Powerball numbers from June 27 drawing
03-16-28-30-59, Powerball: 11, Power Play: 2
Check Powerball payouts and previous drawings here.
Winning Pick 3 numbers from June 27 drawing
Day: 7-6-8, Fireball: 2
Evening: 3-1-0, Fireball: 4
Check Pick 3 payouts and previous drawings here.
Winning Pick 4 numbers from June 27 drawing
Day: 8-0-2-2, Fireball: 9
Evening: 8-1-5-3, Fireball: 0
Check Pick 4 payouts and previous drawings here.
Winning Cash 5 numbers from June 27 drawing
02-08-10-17-28
Check Cash 5 payouts and previous drawings here.
Winning Double Play numbers from June 27 drawing
01-02-15-25-36
Winning Millionaire for Life numbers from June 27 drawing
26-32-38-51-52, Bonus: 05
Check Millionaire for Life payouts and previous drawings here.
Feeling lucky? Explore the latest lottery news & results
Are you a winner? Here’s how to claim your lottery prize
All North Carolina Lottery retailers will redeem prizes up to $599.
For prizes over $599, winners can submit winning tickets through the mail or in person at North Carolina Lottery Offices. By mail, send a prize claim form, your signed lottery ticket, copies of a government-issued photo ID and social security card to: North Carolina Education Lottery, P.O. Box 41606, Raleigh, NC 27629. Prize claims less than $600 do not require copies of photo ID or a social security card.
To submit in person, sign the back of your ticket, fill out a prize claim form and deliver the form, along with your signed lottery ticket and government-issued photo ID and social security card to any of these locations:
- Asheville Regional Office & Claim Center: 16-G Regent Park Blvd., Asheville, NC 28806, 877-625-6886 press #1. Hours: 9 a.m. to 5 p.m. Monday through Friday. This office can cash prizes up to $99,999.
- Greensboro Regional Office & Claim Center: 20A Oak Branch Drive, Greensboro, NC 27407, 877-625-6886 press #2. Hours: 9 a.m. to 5 p.m. Monday through Friday. This office can cash prizes up to $99,999.
- Charlotte Regional Office & Claim Center: 5029-A West W. T. Harris Blvd., Charlotte, NC 28269-1861, 877-625-6886 press #3. Hours: 9 a.m. to 5 p.m. Monday through Friday. This office can cash prizes up to $99,999.
- NC Lottery Headquarters: Raleigh Claim Center & Regional Office, 2728 Capital Blvd., Suite 144, Raleigh, NC 27604, 877-625-6886 press #4. Hours: 9 a.m. to 5 p.m. Monday through Friday. This office can cash prizes of any amount.
- Greenville Regional Office & Claim Center: 2790 Dickinson Avenue, Suite A, Greenville, NC 27834, 877-625-6886 press #5. Hours: 9 a.m. to 5 p.m. Monday through Friday. This office can cash prizes up to $99,999.
- Wilmington Regional Office & Claim Center: 123 North Cardinal Drive Extension, Suite 140, Wilmington, NC 28405, 877-625-6886 press #6. Hours: 9 a.m. to 5 p.m. Monday through Friday. This office can cash prizes up to $99,999.
Check previous winning numbers and payouts at https://nclottery.com/.
When are the North Carolina Lottery drawings held?
- Powerball: 10:59 p.m. Monday, Wednesday, and Saturday.
- Mega Millions: 11 p.m. Tuesday and Friday.
- Lucky for Life: 10:38 p.m. daily.
- Pick 3, 4: 3:00 p.m. and 11:22 p.m. daily.
- Cash 5: 11:22 p.m. daily.
- Millionaire for Life: 11:15 p.m. daily.
This results page was generated automatically using information from TinBu and a template written and reviewed by a Carolina Connect editor. You can send feedback using this form.
An AMBER Alert has been issued for a 15-year-old New Bern boy after police say he was abducted at gunpoint from a motel early Saturday morning.
According to the New Bern Police Department, officers responded around 3:15 a.m. to the Palace Motel, located at 1901 Martin Luther King Jr. Blvd., after receiving a report of a child abduction.
Police said two adults inside the motel room told officers they had been asleep with two boys — 15-year-old Isaiah Kavon Owens and 13-year-old Kenneth Brantley Jr. — when they were awakened by someone banging on the door.
According to investigators, Larry Tompkins opened the door and encountered multiple people, including Kenneth Lee Brantley Sr., the father of Kenneth Brantley Jr.
Police said Brantley pointed a gun at Tompkins before taking both boys from the room and leaving in a black 2012 GMC Yukon Denali XL with South Carolina license plate XFH752.
Authorities said Brantley may be traveling to his residence in Marion, South Carolina. A statewide BOLO (Be On the Lookout) has been issued for the vehicle.
The North Carolina Center for Missing Persons issued an AMBER Alert Friday morning at the request of the New Bern Police Department.
Isaiah is described as a Black male, 5 feet 4 inches tall and weighing approximately 100 pounds. He has black hair and brown eyes and was last seen wearing a white hooded sweatshirt, black pants and red-and-blue sneakers.
Police said Isaiah is autistic and has a speech delay.
Investigators said arrest warrants have been obtained for Brantley charging him with the abduction and endangerment of Isaiah Owens.
The New Bern Police Department said it is working with local, state, out-of-state and federal law enforcement agencies to locate Isaiah and ensure his safe return.
Anyone with information is urged to contact the New Bern Police Department at 252-633-2020, their local law enforcement agency, or call 911 immediately.
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Authorities advise the public not to approach Brantley.
A man once given the nickname Cardiac Kemba due to his heart-stopping heroics at the University of Connecticut, Kemba Walker is back to breathe life into the 704’s youth basketball community.
The Charlotte Hornets’ legend officially opened the Kemba Walker Sports Academy in Concord, North Carolina this afternoon, a multi-sport facility just north of Charlotte that’s mission is “to provide a safe, fun, and inclusive environment for athletes to learn, grow, excel and compete.”
At a ceremony to celebrate the grand opening of the 54,000 square foot facility, Walker took some time to answer questions from assembled media about his latest venture that was created with community in mind.
“It’s really bigger than, you know, basketball,” said the Hornets’ all-time leading scorer this afternoon when talking about the academy. “We want the kids to have some discipline and really teach them how to work hard you know? That’s what we’re chasing. We’re chasing something that’s much bigger than the actual sport.”
It’s a bold vision, and one that Walker has dreamed of fulfilling since he was a kid suiting up for his childhood AAU program, the New York Gauchos.
“(The Gauchos’ facility) is probably not quite like this. It’s not as big as this. But that was my safe space, you know? That was the place I was able to go to, to enjoy the game of basketball and meet some of my closest friends that I still have to this day who actually run this place.”
Walker has been a pillar of the grassroots basketball community in Charlotte since he was a baby-faced, 20-something-year-old suiting up for the Bobcats. And even though he spent some time playing elsewhere in his professional basketball career, the four-time All-Star has considered the Queen City his domain since draft night.
“I never left, first of all” said Walker when asked about returning to the Hornets as an assistant coach and being able to now give back to the community that embraced him with open arms when he was drafted in 2011. “Obviously, I went to a couple of different teams and, you know, my path took me to a couple of different places, but I always kept my house here, and my family was always here, and whenever I had time in the summer, something like that, I was always here.”
“But it is amazing to be back. I love Charlotte.”
And Charlotte loves him back.
Walker stamped his name in the franchise record books with a successful career on the court, but he forever endeared himself into the community by embracing the basketball-crazed city he didn’t have a single tie to until he was drafted there.
The Kemba Walker Sports Academy will host its first grassroots basketball event this weekend, the Kemba Walker Invitational, where AAU teams from across the country (including Walker’s own New York Gauchos) will convene in Concord to christen the facility.
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