Provider Contracting Deadline for Inclusion in Open Enrollment and Auto-Enrollment

Today the North Carolina Department of Health and Human Services (NCDHHS) issued guidance for Provider and Health Plan contract deadlines for inclusion in open enrollment and auto-enrollment as part of North Carolina’s transition to Medicaid Managed Care.

Provider contracts must be signed and mailed to health plan by:

• Feb. 1, 2021, for inclusion in open enrollment, and
• April 12, 2021, for inclusion in auto-enrollment.

During open enrollment for Medicaid Managed Care (March 15, 2021 through May 14, 2021), beneficiaries will choose a health plan and primary care provider (PCP). Those beneficiaries who do not make a choice will be auto-enrolled (commences on May 15, 2021 and runs for six days) in a health plan.

These recommended provider contracting deadlines allow health plans to process provider contracts and ensure that provider records are loaded correctly and transmitted to our Enrollment Broker. This typically takes at least two to three weeks, but it may take longer. Additional time is then needed to transmit information to the Department for inclusion in the open enrollment and auto-enrollment processes.

For more information, please see the Provider and Health Plan Contract Deadlines for Inclusion in Open Enrollment and Auto-Enrollment Medicaid bulletin article.