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:

What to Do When You Can’t Find a Provider

A woman with medium brown skin wearing a jean jacket and turquoise necklace smiles at the camera, her hands on her daughter's shoulders. Her daughter is wearing a bright pink pendant, a beige shirt and has a huge smile on her face and closed eyes. She has an intellectual disability.

I have been approved for services through my local management entity / managed care organization (LME/MCO) but I can’t find a provider agency or my provider agency doesn’t have enough […]

EPSDT Brochures

Three multi-ethnic little girls, one with dark brown skin and her curly hair pulled up in a pony, one with blond hair and bangs and light skin, and one with brown skin and braids, are all smiling with their arms across each other's shoulders. They are in a classroom. EPSDT applies to all children with Medicaid.

Early and periodic screening, diagnostic and treatment (EPSDT) is a program for children under 21 who have Medicaid. Under EPSDT, the state must cover all medically necessary services for children. […]

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.