Sandhills Center announces Medicaid service rate increases

Publication Date: June 28, 2018

Sandhills Center announced today that it will increase reimbursement rates by 3 percent to providers of community-based Intermediate Care Facilities, Outpatient Services including Evaluation and Management Coding, and all Innovations services. The new reimbursement rates will begin with services offered on and following July 1, 2018.

Sandhills Center is a Local Management Entity (LME) and Medicaid-funded Managed Care Organization (MCO) that acts as an agent of the North Carolina Department of Health and Human Services. As an LME-MCO, Sandhills Center provides access to publicly-funded mental health, intellectual/developmental disabilities and substance abuse services for the residents of Anson, Guilford, Harnett, Hoke, Lee, Montgomery, Moore, Randolph and Richmond counties. This announcement continues Sandhills Center’s commitment to reinvesting 1915 (b)/(c) Medicaid Waiver savings into community-based services.

“Sandhills Center values the high-quality services offered by our provider network,” said Victoria Whitt, Chief Executive Officer for Sandhills Center. “We recognize the importance of reinvesting savings back into our local communities so that the provider network can continue to offer appropriate services to our members.”

Community-Based Intermediate Care Facilities (ICF) are a specialized residential option that provide 24/7 care and treatment over an extended period for individuals with intellectual/developmental disabilities. The service offers the wrap-around support necessary for individuals to live in their community and promotes the attainment of the highest level of independent living while also offering care for physical and medical needs.

ICF services are both comprehensive and individualized to meet the needs of individuals served.

Community Outpatient Services are available to provide individuals with thorough assessments and high-quality treatment by licensed practitioners. Treatment may include medication management, individual and group therapy, behavioral health counseling, family therapy and psychological testing.

Evaluation and Management Coding allows psychiatrists, nonpsychiatric physicians, physician assistants and nurse practitioners the ability to effectively plan and monitor integrated treatment around clinical history, examination, and medical decision-making. It allows individuals to receive treatment based on their history with an assessment and clinical care plan based on their needs. It also allows the provider to be reimbursed for time spent counseling and coordinating care for the member.

The Medicaid-funded NC Innovations Waiver is a resource for funding services and supports for people who are at risk for institutional care in an Intermediate Care Facility for Individuals with Intellectual Disabilities. The waiver helps children and adults to live independently within their communities. It promotes choice, control and community integration.