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Chronic Failures Upend Cardinal

DRNC Statement on Cardinal Innovations Merger with Vaya Health

Following months of reports of dissatisfaction about Cardinal’s inadequate provider network and accusations that Cardinal is not adequately serving people with mental health and developmental disabilities in North Carolina, Cardinal has announced a “consolidation” with Vaya Health. According to the announcement on PR Newswire, as part of the consolidation, beleaguered Cardinal Innovations has agreed to cede responsibility for coordinating member services and supports to Vaya Health, another managed care entity serving North Carolina Medicaid participants.

Currently, Cardinal and Vaya are separate entities that manage county, state and Medicaid funds for intellectual/developmental disability, mental health and substance use disorder services. One core function of these entities includes creating adequate provider networks, without which children and adults often end up without community services and are instead forced into institutions, often far away from home and family and friends in violation of state and federal law.

Cardinal’s announcement does not indicate that public scrutiny played a factor in the decision, but the development comes on the heels of reports that counties such as Cabarrus, Mecklenburg, Forsyth, Orange, Stanly, and Union were seeking to disengage or had recently disengaged from Cardinal, and that NCDHHS was starting to allow the counties to do so.

Regardless of the reasons for the organizational change, Disability Rights NC hopes this development is a cautionary tale to other managed care organizations about the consequences of failing to meet the needs of the children and adults they serve, who far too often struggle to secure from these agencies the supports and services they are entitled to and need in their communities. The MCOs must take heed of this development and the NC Department of Health and Human Services must finally take responsibility for ensuring North Carolina’s MCOs uphold their end of the contracts

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