Attention: CAP/C Stakeholders Seeking Members for Clinical Coverage Policy Focus Groups

The CAP/C Home and Community-Based Services Waiver is in its second year of operation. As part of Medicaid's ongoing effort to meaningfully evaluate the administration of CAP/C, the CAP/C unit will conduct quality reviews of the Clinical Coverage Policy, 3K-1, Community Alternatives Program for Children (CAP/C), in the following areas:

  • Eligibility requirements for waiver participation
  • Definitions of terms, coverage and limitations
  • Care coordination through provider networks

Medicaid is seeking volunteers to participate in one of three focus groups to assist with the quality review of the above listed areas. The goals of the quality review will be to evaluate the policy's:

  1. Clarity, conciseness, and ease of application for beneficiaries receiving services and providers rendering services.
  2. Coverage criteria to identify unintended barriers that may limit access to care and needed services.
  3. Care coordination activities to ensure interest-free case management services are being administrated.

The results of the review will serve as a basis for future revisions to the CAP/C Clinical Coverage Policy and  waiver amendment.

An interest meeting regarding this initiative will be held on June 26, 2018 from noon - 1 p.m. by webinar. The quality analysis review of the CAP/C Clinical Coverage Policy will begin the week of July 2, 2018 and conclude on September 30, 2018. The recommendations from the three groups will be shared with the CAP/C Advisory Committee for additional discussion.

If interested in participating, email Rachel Lane at rachel.lane@dhhs.nc.gov and provide your name, contact information and the focus group of your preference; or indicate your willingness to participate in one of the focus groups by registering and attending the webinar on June 26.