North Carolina General Statutes 108D-45. Number and nature of capitated PHP contracts
The number and nature of the contracts required under N.C. Gen. Stat. § 108D-65(3) shall be as follows:
(1) Four contracts between the Division of Health Benefits and PHPs to provide coverage to Medicaid recipients statewide.
Terms Used In North Carolina General Statutes 108D-45
- Contract: A legal written agreement that becomes binding when signed.
- state: when applied to the different parts of the United States, shall be construed to extend to and include the District of Columbia and the several territories, so called; and the words "United States" shall be construed to include the said district and territories and all dependencies. See North Carolina General Statutes 12-3
(2) Up to 12 contracts between the Division of Health Benefits and PLEs for coverage of regions specified by the Division of Health Benefits pursuant to N.C. Gen. Stat. § 108D-65(2). Regional contracts shall be in addition to the four statewide contracts required under subdivision (1) of this section. Each regional contract shall provide coverage throughout the entire region for the Medicaid services required by N.C. Gen. Stat. § 108D-35 A PLE may bid for more than one regional contract, provided that the regions are contiguous.
(3) The limitations on the number of contracts established in this section shall not apply to BH IDD tailored plans described in N.C. Gen. Stat. § 108D-60
(4) Initial capitated PHP contracts may be awarded on staggered terms of three to five years in duration to ensure against gaps in coverage that may result from termination of a contract by the PHP or the State. (2015-245, s. 4; 2016-121, s. 2(b); 2018-48, s. 1; 2019-81, s. 14(a); 2022-74, s. 9D.15(z).)