NC H403

Increases the number of statewide Prepaid Health Plan (PHP) contracts from three to four for Medicaid and NC Health Choice coverage.

Restricts behavioral health services coverage under standard PHP contracts to specific services only (inpatient, emergency, outpatient, crisis management, detoxification, and treatment services), while excluding comprehensive behavioral health services currently managed by Local Management Entities/Managed Care Organizations (LME/MCOs).

Exempts certain populations from enrollment in standard PHPs, including recipients with serious mental illness, serious emotional disturbance, severe substance use disorder, intellectual/developmental disabilities, and traumatic brain injury, until new Behavioral Health and Intellectual/Developmental Disability (BH IDD) Tailored Plans become operational.

Establishes BH IDD Tailored Plans as specialized capitated contracts operated initially by LME/MCOs only, to be implemented no earlier than August 31, 2018, with 5-7 regional contracts covering comprehensive behavioral health and disability services.

Requires the Department of Health and Human Services to report to the Joint Legislative Oversight Committee by June 22, 2018, with a detailed implementation plan for BH IDD Tailored Plans, including transition processes, contract parameters, and measurable outcomes.