By Berkeley Yorkery
The deadline for submitting a proposal to be a Standard Prepaid Health Plans (PHP) vendor under Medicaid transformation passed last week and federal approval for the Medicaid Transformation is expected any day. This means Medicaid transformation in North Carolina is moving toward the implementation stage, and stakeholders should prepare for change.
One of the biggest changes under Medicaid Transformation will be the move from one Medicaid plan to many. Currently, the vast majority of Medicaid beneficiaries are in the same program, and Medicaid is administered by the state. Under transformation, there will be multiple types of PHPs and multiple PHP vendors.
NC DHHS has announced two types of PHPs:
Both types of plans will cover the same benefits and populations and will have to meet the same requirements. Tailored plans will offer some enhanced benefits.
Current Timeline 
The NC Department of Health and Human Services will award Standard Plan PHP contracts in February. There are expected to be up to four commercial Standard PHPs offered statewide and up to 12 regional provider-led entity Standard PHPs . Once contracts are awarded, PHPs will begin contracting with providers and preparing for enrollment by opening call centers. NC DHHS has announced that the transition to Standard Plan PHPs will take place in two phases but has not announced which regions will be included in each phase. Medicaid enrollees in regions in phase 1 will enroll between July and September of 2019, with the PHPs launching November 1. Those in regions in phase 2 will enroll between October and December of 2019, with the PHPs launching in February of 2020.
If these timelines hold, the next year will be one of rapid acceleration of Medicaid Transformation in North Carolina.
 North Carolina Department of Health and Human Services has designated six Medicaid regions for Medicaid Transformation. https://files.nc.gov/ncdhhs/Proposed-Regions-Map-2016-03-01.pdf