Chapter 108D - Medicaid and NC Health Choice Managed Care Programs.

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Chapter 108D
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Article 1 - General Provisions.
G.S. 108D-1
§ 108D-1. Definitions.
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G.S. 108D-2
§ 108D-2. Scope; applicability of this Chapter.
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G.S. 108D-3
§ 108D-3. Conflicts; severability.
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Article 1A - Disenrollment from Prepaid Health Plans.
G.S. 108D-5.1
§ 108D-5.1. General provisions.
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G.S. 108D-5.3
§ 108D-5.3. Enrollee requests for disenrollment.
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G.S. 108D-5.5
§ 108D-5.5. PHP requests for disenrollment.
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G.S. 108D-5.7
§ 108D-5.7. Notices.
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G.S. 108D-5.9
§ 108D-5.9. Appeals of adverse disenrollment determinations.
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Article 2 - Enrollee Grievances and Appeals.
G.S. 108D-11
§ 108D-11. Managed care entity grievance and appeal procedures, generally.
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G.S. 108D-12
§ 108D-12. Managed care entity grievances.
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G.S. 108D-13
§ 108D-13. Standard managed care entity level appeals.
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G.S. 108D-14
§ 108D-14. Expedited managed care entity level appeals.
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G.S. 108D-15
§ 108D-15. Contested case hearings on disputed adverse benefit determinations.
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G.S. 108D-16
§ 108D-16. Notice of final decision and right to seek judicial review.
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Article 3 - Managed Care Entity Provider Networks.
G.S. 108D-21
§ 108D-21. LME/MCO provider networks.
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G.S. 108D-22
§ 108D-22. PHP provider networks.
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G.S. 108D-23
§ 108D-23. BH IDD tailored plan networks.
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Article 4 - Prepaid Health Plans.
G.S. 108D-30
§ 108D-30. Intent and Goals.
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G.S. 108D-35
§ 108D-35. Services covered by PHPs.
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G.S. 108D-40
§ 108D-40. Populations covered by PHPs.
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G.S. 108D-45
§ 108D-45. Number and nature of capitated PHP contracts.
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G.S. 108D-50
§ 108D-50. Defined measures and goals.
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G.S. 108D-55
§ 108D-55. Administrative functions.
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G.S. 108D-60
§ 108D-60. BH IDD tailored plans.
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G.S. 108D-65
§ 108D-65. Role of the Department.
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G.S. 108D-70
§ 108D-70. Advanced Medical Homes.
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