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 […]

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.

Am I Eligible for CAP/DA?

Woman in wheelchair with oxygen supply holds young girl

Community Alternatives Program for Disabled Adults (CAP/DA)  CAP/DA is a Medicaid Waiver program that allows the elderly and adults with disabilities to receive their care in their own home, or […]

Am I Eligible for an Innovations Waiver?

Black man with I/DD sits in front of flowers in a community garden

The Innovations Waiver is a Home and Community-Based Service Waiver under the Medicaid program that provides services to people with intellectual and/or developmental disabilities (like Autism, Cerebral Palsy, Down Syndrome, etc.). The […]