Medicaid Appeals Involving LME/MCOs

White man in his 30s reads letter from LME/MCO denying request for services for his disabled brother.

If you receive Medicaid services, you have the right to appeal any denial, reduction, suspension, or termination of services. In North Carolina, Local Management Entities/Managed Care Organizations (LME/MCOs) administer behavioral health services. They decide what services you can have. You can appeal the LME/MCO’s decision to do any of the following:

Autism-Related Services in NC

child with autism identifies emotions using cards held up by psychologist during play therapy

Changes to the Waiver rules: your Individual Budget, your right to request services beyond your budget, and tips on your ISP.

Personal Care Services

Home health aide wearing a facemask while assisting a senior woman walking with a mobility walker- personal care services

What are personal care services? How do you apply? You may be eligible for this Medicaid service if you need hands-on assistance for ADLs.