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Mailing Address:

LME/MCO Realignment
600 East 4th Street, 11th Floor
Charlotte, NC 28202


Office Location:

600 East 4th Street, 11th Floor
Charlotte, NC 28202
Hours: Mon-Fri 8 a.m. - 5 p.m.

Contact

Realignment Inquiries

​Frequently Asked Questions

​These questions and answers are provided to help Mecklenburg County residents and healthcare providers better understand the proposed transition of the County's management of Medicaid and uninsured benefits from Cardinal Innovations Healthcare to Alliance Health.

Why is Mecklenburg County seeking to realign with Alliance Health?
In April 2014, Cardinal Innovations Healthcare began operating as the Local Management Entity/Managed Care Organization (LME/MCO) for Mecklenburg County.  LME/MCOs contract with the North Carolina Department of Health and Human Services (NCDHHS) to manage behavioral health (including mental health and substance use disorder) and intellectual/developmental disability (I/DD) services for residents who are insured by Medicaid or who have no health insurance (such residents receiving services are referred to as "Members" throughout these FAQ responses).  LME/MCOs use state and federal dollars allocated to them by NCDHHS to authorize, pay for, manage, and monitor behavioral health and I/DD services provided by healthcare professionals in the provider network of the LME/MCO.    

Realignment means changing which LME/MCO manages the County's behavioral health, I/DD, and substance use disorder services for Mecklenburg County Members.   Since 2014, Mecklenburg County has experienced significant issues in the delivery of behavioral health services to County residents.  Mecklenburg County has engaged in numerous meetings with Cardinal and community stakeholders to address these concerns.  In October 2020, Mecklenburg County, along with Forsyth County, sent a letter to Cardinal and the Secretary of NCDHHS to express concerns regarding Cardinal's services and requesting an action plan to address these concerns.  Cardinal developed an action plan; however, the plan did not appropriately address the ongoing concerns.   

Alliance is an LME/MCO in good standing with NCDHHS.  Alliance currently serves Wake, Durham, Johnston and Cumberland counties and has used innovative ideas to address behavioral health issues within these communities.  Alliance has experience working with urban areas such as Mecklenburg County and approaches behavioral health with a collaborative approach.  Alliance works with a network of almost 2,200 private providers across its current four-county service area to serve the needs of over 430,000 Medicaid-eligible and uninsured individuals within a total population of 1.8 million.



What is the timeline for realigning with Alliance?  
On August 6, 2021, the North Carolina Department of Health and Human Services (NCDHHS) approved Mecklenburg County's request to realign with Alliance Health as the Local Management Entity/Managed Care Organization (LME/MCO) for the County.  Alliance will assume responsibility as LME/MCO for Mecklenburg County by December 15, 2021, according to a timetable established by NCDHHS.  On June 1, 2021, the Mecklenburg Board of County Commissioners voted unanimously (with one abstention) to disengage from Cardinal Innovations Healthcare and realign with Alliance.

More information regarding the realignment process can be located on the Mecklenburg County Realignment website and the Alliance Health Realignment website.



What type of community involvement should we expect from Alliance?
Working with the County and Cardinal, Alliance Health has reached out to current and former Consumer and Family Advisory Committee (CFAC) members representing Mecklenburg County to establish a dialogue to receive their input on issues affecting the public behavioral healthcare system locally and statewide.  Alliance will also support the development of a charter and member recruitment for a local Alliance Mecklenburg County CFAC.

Alliance prioritizes a system of care approach to build on the strengths of individuals, forge partnerships, improve access to services, and understand the story of the people and families it serves in a more complete way.  To build a community-based System of Care in Mecklenburg County, Alliance will work with local organizations and public partners to address social and environmental factors, including homelessness, food insecurity, and lack of transportation, that particularly impact the overall health and quality of life of individuals that lack health coverage.  Alliance utilizes community collaboratives and roundtables with shared goals and accountability to achieve worthwhile, sustainable outcomes.  Alliance has begun establishing these opportunities in Mecklenburg County.

Additionally, Alliance has Outreach and Education as well as Member and Community Engagement teams that help individuals navigate the human services system and utilize available local resources. These teams provide various trainings on topics including Medicaid Transformation and health wellness and prevention.  By providing diverse communities the tools they need to succeed – from education and training, to the development of care guidelines and system navigation – Alliance aims to enable people to lead healthier, more satisfying lives.

Alliance recognizes the importance of sharing information about the LME/MCO realignment as transparently as possible with County residents and families currently served by Cardinal, current service providers in Cardinal's provider network in the County, and other impacted stakeholders.  Alliance is working in collaboration with the County and Cardinal to provide relevant information to such stakeholders throughout this transition in a timely manner, including by utilizing our respective websites and social media platforms and through live and/or virtual stakeholder meetings and other community events.



What impact will realignment have on Members?
All impacted Members will be contacted by Alliance in advance of the transition.  Currently authorized services will continue and healthcare providers that are currently providing services to Members will be offered a contract to continue those services through Alliance.  It is the intent of both the County and Alliance to ensure a seamless transition from Cardinal to Alliance and prevent disruptions in services for Members and providers.
 



Will Members have to take steps to enroll with Alliance?
No.  If you are currently receiving mental health, substance use disorder, or I/DD services through Cardinal, you will be automatically enrolled with Alliance when the realignment takes place on December 15, 2021.   
 


How do I locate information regarding Alliance Health?
You can visit the Alliance Health website for the latest information.
 


What will happen with service authorizations pending at the time of the transition? Will they have to be redone and resubmitted?
At go-live of the LME/MCO realignment, Alliance will make every effort to honor all existing service authorizations for Members and any Member's Individual Support Plan to ensure a smooth transition and prevent disruptions in services.



What will happen if Alliance does not offer the same services that Cardinal offers?

Alliance is committed to maintaining the same services whenever possible and agrees to work to add services to its service array when necessary.  Differences in available services will be identified during the implementation planning prior to the realignment effective date of December 15, 2021.  Additionally, Alliance has agreed to contract with providers that are in good standing that are currently contracted with Cardinal to serve Mecklenburg County residents.  In the event that Alliance is unable to provide a specific state-funded service that is available in Mecklenburg County currently, Alliance has committed to working with local service providers and individuals and families to identify and ensure appropriate services are made available.




Will there be any changes to the provider network?
It is the intent of Alliance Health to ensure a seamless transition from Cardinal to Alliance and prevent disruptions in services for Members and providers.  Alliance agrees to bring into its network, to continue to serve Members and Mecklenburg County, providers that are in good standing with Cardinal and Alliance and meet all the applicable state-imposed rules and requirements. 



What will be the process to join the Alliance Health Provider Network if a provider is not currently contracted with Alliance?
In order to ensure a smooth transition and prevent disruptions in services for Members and providers, Alliance is opening its Provider Network to providers that are currently serving Mecklenburg County residents, are in good standing with Cardinal and Alliance, and meet all the applicable state-imposed rules and requirements.  The first step in the contracting process is for providers to submit an Enrollment Application Packet to Alliance.  Alliance requests that these provider Enrollment Application Packets be completed and submitted by September 30, 2021.

Providers that have been credentialed by Cardinal and are currently under contract with Cardinal serving Mecklenburg County residents will not need to go through the full credentialing process with Alliance.  There will be information that Alliance will require for the enrollment verification and contracting process, but Alliance will be using data from NCTracks and from Cardinal to obtain such information.

For any type of support needs or questions, providers can contact the Alliance Provider Helpdesk at ProviderNetwork@alliancehealthplan.org or (919) 651-8500.    




What will happen when rates that are currently being paid to providers for services in Mecklenburg County are higher than Alliance's current provider rate?
Each LME/MCO sets its own rates.  At this stage in the process, Alliance does not yet know all of Cardinal's provider rates.  However, Alliance will continue to honor Cardinal's base rates as of December 31, 2020 for providers serving Mecklenburg County Members for the foreseeable future (barring any changes to state and/or Medicaid funding that would necessitate broader changes to Alliance provider rates across its service area). 
 
To confirm these service details, information is required from Cardinal regarding the services being provided in Mecklenburg County as well as the funding available from the State.  This information has been requested from Cardinal. 



What experience do Alliance's care managers have?
Alliance's care managers serve a variety of groups including people living with I/DD, in recovery from mental health and substance use disorder issues, and survivors of traumatic brain injury (TBI).  The organization's 200+ Care Management staff are trained to support children and adults specific to the programs in which they are enrolled and according to the services that they receive.  Alliance's staff is diverse in their years of experience and many have professional work experience as providers and practitioners of behavioral health services as well as service managers through the LME/MCO system.  Some have worked for multiple LME/MCOs.

In addition, Alliance has staff who have lived experience themselves or have experience supporting family members living with I/DD, mental health or substance use disorder issues, or TBI.  Alliance's care managers have high integrity and compassion in the way that they approach their work.  As part of Alliance's ongoing quality measures, an annual survey is offered to each Member served by the Alliance Care Management Department to check on the customers' experiences with care management.  Alliance encourages input on our operations and process improvement through Consumer and Family Advisory Committees (CFACs), stakeholder groups, and the Alliance Quality Management Department.

In preparation for Mecklenburg County joining Alliance on December 15, 2021, and in preparation for operating a Behavioral Health I/DD Tailored Plan in July 2022, Alliance is scaling up with plans to hire around 450 new staff as it grows to serve new members, families, providers, and parts of the state.  Alliance career opportunities in multiple fields are available in Mecklenburg County. Alliance has informed existing care managers working for Cardinal of employment opportunities with Alliance to serve Members in the County.  Alliance is interested in considering these individuals for employment and encourages them to consider such opportunities. 



Does Alliance allocate Innovations Waiver slots differently than Cardinal?
No.  North Carolina equitably distributes Innovations Waiver slots throughout the state based on county population.  LME/MCOs then equitably distribute the slots within their respective catchment areas based on county population percentage of the total population of an LME/MCO's service area.  No Mecklenburg County resident with an Innovations slot currently will lose their slot when realignment occurs.



Who do I contact if I have questions?
You can visit the Mecklenburg County website and the Alliance Health website at for the latest information. 

You may email questions to Realignment@MecklenburgCountyNC.gov or mail questions to Realignment, 600 East Fourth Street, 11th floor, Charlotte, NC 28202.

 

 


Address

Mailing Address:

LME/MCO Realignment
600 East 4th Street, 11th Floor
Charlotte, NC 28202


Office Location:

600 East 4th Street, 11th Floor
Charlotte, NC 28202
Hours: Mon-Fri 8 a.m. - 5 p.m.

Contact

Realignment Inquiries