New 3-Party Provider Contracts for Carolina Access Providers
All Providers in our network will receive new Partnership for Community Care Provider Agreements. The new agreement must be signed and returned to us by March 15, 2013. The primary provider responsibilities, local Care Management services, and the per-member, per-month (PMPM) management fee have NOT changed.
The CCNC Contract: What’s New?
- Effective January 1, 2013, there is one managing contract (the “Master Contract”) between Community Care of North Carolina and the Division of Medical Assistance (DMA). Until December 2012, each of the 14 CCNC networks had its own three-way agreement with DMA and CCNC.
- The single contract will help ensure a more accountable system of care for managing the Medicaid program statewide by ensuring CCNC’s central organization holds all 14 regional networks accountable to common, statewide performance measures.
What does this mean for my practice?
To reflect the new Master Contract between DMA and CCNC, a new agreement has been created for our enrolled practices. This is a three-way agreement between CCNC, the local CCNC network – in this case Partnership for Community Care, and the practice. Each enrolled practice must sign a new contract.
The new agreement is 24-pages long, a noticeable increase from the previous agreement. The length can be attributed to newly added language that specifically outlines the duties of the CCNC networks. Only a small portion of the new contract (pages 16-18) pertains to the duties of the practice. The majority of these duties remain unchanged from the contract obligations your practice signed in the past.
What has NOT changed with the new agreement are the primary provider responsibilities and the per-member, per-month management (PMPM) fee. CCNC remains provider driven and continues to put responsibility for performance and improvement in the hands of our providers. Your practice PMPM payments will continue to come directly from DMA.
We apologize in advance for the administrative burden this may cause your practice. If you have questions about the new contract, please contact Brooke Kochanski at 336-235-0930 ext. 314 or [email protected]. We are eager to assist and grateful for your cooperation and support.