NCB testing #449

Request for Proposal (RFP): Individual Placement and Support (Supported Employment)

The purpose of this Request for Proposal (RFP) is to invite service providers to increase access to Individual Placement and Support-Supported Employment (IPS-SE) in Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, Hyde, Martin, Northampton, Pasquotank, Perquimans, Tyrell, and Washington counties.

• Request for Proposal-Individual Placement and Support (Supported Employment)

NCTracks Quick Links

• Message from the DMH/DD/SUS Director
• Supporting Community Recovery: A Visit to Tia Hart Peer Recovery Community Center
• DMH/DD/SUS Supports Recovery Efforts in Wilson County
• NC Selected for 2026 Crisis Systems Design Policy Academy
• Side by Side with DMH/DD/SUS Year-in Review: DMH/DD/SUS Strategic Plan
• Rural Health Transformation Program Town Hall
• Inclusion Work Community Advisory Committee Meeting
• State Consumer and Family Advisory Committee

Reminders

Medicaid Behavioral Health Rate Restoration Update

Reversal of NC Medicaid Rate Reductions

On December 10, 2025, the North Carolina Department of Health and Human Services (NCDHHS) announced that it will reverse the Medicaid rate reductions that were implemented on October 1, 2025. Trillium Heath Resources is committed to collaborating with providers to restore all reimbursement rates to the levels in effect as of September 30, 2025, or to the appropriate rate as set by the fee schedules being released on January 5, 2026. Please note that billing or rate changes announced by Trillium between October 1, 2025, and December 31, 2025, will remain in effect as outlined.>

Recoupments

Trillium did not begin implementing the rate reductions until November 1, 2025. In anticipation of a resolution to the rate reduction issue, the rate differential for services provided from October 1, 2025 to October 31, 2025 has not been recouped. As a result, there will be no outstanding recoupments related to the October 1 fee schedule changes.

Revised Fee Schedules

NCDHHS has informed NC Medicaid health plans that updated NC Medicaid Direct fee schedules will be posted on the Fee Schedules and Covered Codes Portal by January 5, 2026. These updated schedules will reflect the annual procedure code changes. Trillium will post updated rate schedules on the Rates & Check Write Schedule webpage once finalized.

Important Dates

NCDHHS has notified NC Medicaid health plans that updated rate schedules must be implemented by February 19, 2026, with all affected claims to be reprocessed by March 21, 2026. These dates are contingent upon the timely receipt of updated fee schedules from NCDHHS on January 5, 2026. Trillium will begin implementing the new fee schedules as soon as they are received, but no later than 45 days after the issuance of the revised schedules. Providers are encouraged to continue monitoring communications from Trillium for additional details and updates regarding the timeline.

Reprocessing and Interim Claims

Providers will not need to take any action for claims to be reprocessed. While Trillium has up to 30 days to reprocess claims following the implementation of the updated fee schedules, we are committed to doing so promptly to ensure timely payment to providers. Information regarding interim claims will be communicated in an upcoming Network Communication Bulletin.

GLP-1 Retroactivity

Previously denied or end-dated prior authorizations for weight loss treatments under the policy effective from October 1 to December 12, 2025, must be resubmitted for evaluation under the updated criteria. Trillium is unable to re-adjudicate previously denied point-of-sale pharmacy claims without an approved prior authorization on file. However, if a prior authorization is under active appeal and the member meets the updated coverage criteria, the authorization will generally be approved.

For additional information, please refer to the following NC Medicaid Bulletins: · Medicaid Rate Reduction Reversal Update · NC Medicaid to Reinstitute Coverage of GLP-1s for Weight Management · Non-Emergency Medical Transportation Rate Reduction Update.

2025-2026 National Core Indicators - I/DD Survey

Trillium is partnering with NCDHHS to support the annual National Core Indicators (NCI) survey, which evaluates the outcomes of individuals receiving Intellectual and Developmental Disability (I/DD) services. This survey examines critical areas such as employment, community involvement, relationships, health and wellness, safety, and access to services. Standardized questions allow for comparisons between states and provide valuable insights into service quality.

How Providers Will Be Involved 

Beginning in December 2025, providers serving members with I/DD aged 18 and older may be contacted to assist in the following ways: 

• Obtaining member consent for survey participation. 
• Providing background information for consenting members. 

Survey administration will be handled by the Carolina Institute for Developmental Disabilities (CIDD), a third-party organization contracted by the State. 

Eligibility Requirements for Survey Participation

Members must meet the following criteria to participate in the survey: 

• Be diagnosed with an intellectual or developmental disability. 
• Receive Medicaid-funded services from an I/DD provider agency. 
• Be at least 18 years old. 

Next Steps for Providers 

If your agency provides services to eligible members, please email Surveys@TrilliumNC.org with contact information for the point of contact for the NCI-IDD survey within your agency as soon as possible. Trillium will send additional details, including the list of members selected to participate, via email. 

For questions or more information, contact Surveys@TrilliumNC.org or call 1-866-998-2597 and ask for Irmak Sherrod. 

Thank You for Your Partnership 

Your support is essential to the success of this important initiative, which helps evaluate and improve services for individuals in our community.

Message from NCTracks: Connecting Communities and Medicaid (CCM) Meetings Resume

We’re pleased to announce the resumption of Connecting Communities and Medicaid (CCM) meetings, an initiative from NC Medicaid. CCM is designed to strengthen collaboration between community organizations and Medicaid services across North Carolina.

What is CCM?

Connecting Communities and Medicaid (CCM) is a strategic effort to build bridges between Medicaid programs and the community-based organizations that support North Carolinians every day. Through regular meetings, shared resources, and open dialogue, CCM aims to exchange information between NC Medicaid and community organizations to reduce barriers to care and ensure that Medicaid services are responsive to the needs of our communities.

Why Join Now?

As we resume our monthly meetings, we will place a special focus on supporting the implementation of H.R.1 requirements and ensuring that community voices are central to this process. By joining CCM, you’ll be part of a collaborative network working to:

• Stay informed about Medicaid updates and federal policy changes
• Share feedback and insights from your community
• Collaborate with other organizations across the state
• Help shape a more inclusive and effective Medicaid system

Kickoff Meeting Details:

• Date: Wednesday, Jan. 14, 2026
• Time: 8:30 AM EST 
• Location: Zoom (link will be provided upon registration) 
• Ongoing Meetings: Every 2nd Wednesday of the month 
• Sign Up to Join CCM: CCM Registration Form

We look forward to reconnecting and working together to build stronger, healthier communities across North Carolina.

Required Update for All HCBS Provider Contact Information

Objective:

NC Medicaid is enhancing the Home and Community Based Services (HCBS) Database to maintain compliance with the HCBS Final Rule and the Centers for Medicare & Medicaid Services (CMS)-approved HCBS Final Transition Plan. All providers of HCBS in North Carolina must update their contact information to support this initiative. More details regarding the database enhancement project will be provided soon.

Action Required by Providers:

After December 19, 2025, all providers offering HCBS (including 1915(c) Waivers: Innovations, TBI and Community Alternatives Program for Disabled Adults (CAP/DA) Adult Day Health services) are required to update their contact information for each submitted and approved Provider Self-Assessment site.

• Deadline: February 28, 2026

How to Complete the Update:

Your assigned health plan(s) will send you a spreadsheet detailing your approved, validated HCBS sites. Follow these steps:

1. Review columns AF and AG (Contact email and contact number) of the spreadsheet to identify any needed updates.
2. Update the contact information directly in the spreadsheet if changes are necessary.
3. Return the completed and updated spreadsheet to your Health Plan contact.

Important Notes:

• Do not update the Provider Self-Assessment in the database directly.
• Only use the spreadsheet provided by your assigned Health Plan(s).
• Your health plan will provide specific guidance on completing and returning the required updates.
• Health plans are responsible for uploading the edited data and submitting it to NC Medicaid.  

Provider Forum Survey Announcement

Trillium Health Resources is requesting feedback from contracted providers through the Provider Forum Survey.
The survey focuses on your experience with Provider Forums, including topics, communication, and overall usefulness. Your input helps us improve future forums and better support your organization.

The survey below takes about five minutes to complete.  Thank you for sharing your feedback and for your continued partnership with Trillium Health Resources.

Provider Forum Survey

Advanced Training Courses for Direct Support Professionals

The North Carolina Department of Health and Human Services, in partnership with the NC Community College System, is excited to continue the free Advanced Direct Support Professional (DSP) Training program for current and aspiring DSPs. Registration for Spring 2026 courses is open now with courses beginning in January 2026. 

Program Highlights:

• Two eight-week virtual courses for flexible participation
• Offered through Stanly, Asheville-Buncombe, and Forsyth Technical Community Colleges

Designed to enhance skills and open career opportunities in supporting people with intellectual and developmental disabilities.

Registration Information:

• Asheville-Buncombe Technical Community College: A-B Tech Direct Support Professional Training  
• Stanly Community College: Stanly Direct Support Professional Training
• Forsyth Technical Community College:
• Call 336-734-7023 and ask to register for Direct Support Professional training courses

Visit the Forsyth Tech Direct Support Professional Training webpage to learn more

Provider Information Sessions: NC Child Welfare Trauma-Informed Assessment

Help shape the future of trauma-informed care in North Carolina! The North Carolina Child Welfare Trauma-Informed Assessment (NC CWTIA) will bring standardized, trauma-focused assessments to child welfare. Attend one of the sessions to learn how your agency can apply to participate as an approved provider. 

Notice of Rate Adjustment: Peer Support Group (H0038HQ)

Trillium Health Resources is implementing a rate adjustment for Peer Support Group Services (H0038HQ). Beginning January 1, 2026, the reimbursement rate will set to $3.74.

The updated rate will apply to all dates of service on or after January 1, 2026. Providers should review their billing processes, service delivery, and any related internal procedures to prepare for this transition.

For questions or additional clarification, please contact the Trillium Rates Team at RatesFinance@TrilliumNC.org.

We appreciate your continued partnership and commitment to supporting members in our network.

Claims Inquiry Submissions

As part of our efforts to streamline communication and improve efficiency, the Claims Inquiry Form will be removed from our website effective 1/9/2026.

Moving forward, providers should continue to submit all claim-related inquiries through our Claims Support ticket queue via ClaimsSupport@TrilliumNC.org.  This centralized process will allow us to ensure faster routing and response times and increase overall communication and follow up.

Mobile Crisis is Live!

Trillium in partnership with Integrated Family Services, Daymark, and Southeastern Integrated Care has expanded State funded, Medicaid Tailored Plan, and Medicaid Direct Mobile Crisis Management (MCM) services into Robeson, Scotland, Hoke, Lee, Moore, Anson, Richmond, Montgomery, Randolph and Guilford counties.  

Mobile Crisis Management involves all support, services and treatments necessary to provide integrated crisis response, crisis stabilization interventions, and crisis prevention activities. MCM services are available anytime, 24 hours a day, 7 days a week, and 365 days a year.  

Crisis response provides an immediate evaluation, triage and access to acute mental health, intellectual/developmental disabilities, or substance abuse services, treatment, and supports to effect symptom reduction, harm reduction, or to safely transition persons in acute crises to appropriate crisis stabilization and detoxification supports or services. These services include immediate telephonic or telehealth response to assess the crisis and determine the risk, mental status, medical stability, and appropriate response.

Request for Application (RFA) High-Fidelity Wraparound Services

Trillium Health Resources is expanding High-Fidelity Wraparound (HFW) Services within Trillium’s catchment area and is recruiting providers for the following identified counties: Northampton, Hertford, Pamlico, Hyde, Dare, Tyrrell, and Washington. 
Trillium is seeking providers that demonstrate the capability and capacity to provide HFW services to achieve desired outcomes; including increased family assets and functioning and reduced out-of-home residential treatment and inpatient hospitalizations.

For more information and application, please visit our Request Opportunities section on the website.

Culturally & Linguistically Competent Care - Training Alerts & Update

Trillium is committed to equitable, person-centered care. Review the latest cultural competency training opportunities and recently updated, NCDHHS-approved training.

• View current training and updates here. 

Provider My Learning Campus Reminder

To find updated and current Provider Trainings, please visit: 

• Provider My Learning Campus or this list of provider trainings.