MedicaidAdministrativeMedium impact
Updated Guidance on Birth Month Alignment for 1915(i)
NC Medicaid - NCDHHS·NC·Provider Bulletin
We identified it
Aug 26, 2026
Summary
NC Medicaid has updated the 1915(i) Assessment Form by removing the eligibility end date field, which previously could shorten members' 1915(i) eligibility periods. The policy now aligns eligibility and Care Plan/Individual Support Plan (ISP) timeframes with each member's birth month for a full 365-day coverage period. Care managers and 1915(i) service providers must review updated training materials to implement this revised assessment approach.
Action Required
Immediately: Care managers and 1915(i) service providers must review the updated NC Medicaid 1915(i) Assessment Form and all training materials (1915(i) Birth Month Alignment Training Deck, Training Video, and Assessment Tool Training Presentation Slides) available on the NC Medicaid website. Billing and care coordination teams should update internal processes to ensure all 1915(i) eligibility determinations use the revised form without end date fields and align timeframes to members' birth months for full 365-day periods. Verify that Carelon and all relevant staff are familiar with the updated process. Direct questions to DHHS-Medicaid.1915iSupport@dhhs.nc.gov. Failure to implement the updated form may result in incorrect eligibility determinations and claim processing delays.