Issued:  June 17, 2020

State Funded Services – UCR and Non-UCR

Partners has received a substantial reduction in our tentative allocation of IPRS/State funds from North Carolina Department of Health and Human Services (NC DHHS) for FY 2020-2021. With the new fiscal year beginning in two weeks, it is important to process contracts for execution. Partners continues to work with NC DHHS in hopes of a more equitable distribution of IPRS/State funds. We are also actively advocating for additional funding during this short session of the General Assembly. However, we can only allocate the funding that is provided to us by DHHS. If additional funding is subsequently provided, we will amend contracts accordingly.

FY 2020-2021 contracts for IPRS/State-funded services will reflect a decreased annual funding capitation and providers should closely monitor expenditures in order to stay within contracted annual amounts. Provider contract capitation will be based on FY 2019-2020 utilization. Contracts for periodic services only will be decreased by 17%. This includes both UCR and Non-UCR contracts. Provider contracts for both residential and periodic services will include a 10% reduction for periodic services and no decrease for residential services.

(b)(3) Services and Medicaid Eligibility

Partners will continue to collaborate with our provider community to stretch the IPRS/State funding that is available for members who do not qualify for Medicaid or other funding. We encourage providers to include Medicaid (b)(3) services, or other Medicaid services in their service arrays to assist Medicaid-eligible members. Provider contracts for (b)(3) services will be reduced by 25% for FY 2020-2021.

We also encourage providers to work with county Departments of Social Services to enroll individuals receiving state-funded services in Medicaid if they meet eligibility requirements. If you have additional questions related to this topic, please contact your Account Specialist.