Due to the government shutdown, updates to information on this website may be limited or delayed. State Medicaid and Children’s Health Insurance Programs (CHIP) continue to operate. Continue to work with the programs in your state to access coverage. For more information about government operating status, visit OPM.gov.

U.S. flag

An official website of the United States government

North Carolina Medicaid Reform Demonstration

State: North Carolina
Waiver Authority:
1115
Status: Approved

Waiver Dates

Approval: 10/19/2018
Effective: 01/01/2019
Expiration: 12/09/2029

Supporting Documents

Approved Application(s) and Related Documents

Date Title
06/25/2025 Monitoring Redesign Overlay Letter (PDF, 5.39 MB)

Administrative Record

Date Title View
05/30/2025 State Letter on HOP Service and Eligibility Updates (PDF, 441.85 KB)
05/30/2025 State Letter on HOP Service and Eligibility Updates (Attachment L, Attachment M, and Attachment N) (PDF, 755.11 KB)
05/29/2025 SUD Quarterly Metrics Report (Part A) – August – October 2024 (XLSX, 598.34 KB)
05/29/2025 SUD Quarterly Report (Part B) – August – October 2024 (PDF, 3.79 MB)
04/29/2025 Quarterly Monitoring Report – November 2024 - January 2025 (PDF, 544.97 KB)
02/28/2025 SUD Annual Report (Part B) – August 2023 to July 2024 (PDF, 4.08 MB)
02/14/2025 Annual Monitoring Report - November 2023 - October 2024 (PDF, 827.84 KB)
01/16/2025 Demonstration Approval (PDF, 4.24 MB)
01/16/2025 HRSN Rates Approval Letter (PDF, 864.3 KB)
01/13/2025 Demonstration Approval - HIT Programs Post-Approval Protocols (PDF, 4.18 MB)
01/07/2025 State Acceptance Letter – Extension STCs (PDF, 727.14 KB)
12/18/2024 CMS Approval – HOP Post-Approval Protocols (PDF, 4.1 MB)
12/18/2024 CMS Approved Managed Care Interim Evaluation Report (PDF, 12.69 MB)
12/10/2024 CMS Approval - Demonstration Extension (PDF, 3.18 MB)
12/09/2024 Quarterly Monitoring Report - May - July 2024 (PDF, 602.26 KB)
10/30/2024 SUD Quarterly Metrics Report (Part A) – February to April 2024 (XLSX, 571.74 KB)
10/30/2024 SUD Quarterly Report (Part B) – February to April 2024 (PDF, 3.97 MB)
10/23/2024 CMS Temporary Extension Approval (PDF, 169.59 KB)
07/26/2024 SUD Quarterly Metrics Report (Part A) – November 2023 to January 2024 (XLSX, 575.63 KB)
07/26/2024 SUD Quarterly Report (Part B) – November 2023 to January 2024 (PDF, 3.93 MB)
06/28/2024 Quarterly Monitoring Report - February - April 2024 (PDF, 534.38 KB)
05/01/2024 SUD Quarterly Metrics Report (Part A) – August to October 2023 (XLSX, 571.93 KB)
05/01/2024 SUD Quarterly Report (Part B) – August to October 2023 (PDF, 3.9 MB)
04/16/2024 CMS Approved Healthy Opportunities Pilots Interim Evaluation Report (PDF, 2.41 MB)
04/03/2024 Quarterly Monitoring Report - November 2023 - January 2024 (PDF, 549.79 KB)
03/15/2024 SUD Annual Report (Part B) – August 2022 to July 2023 (PDF, 3.87 MB)
03/15/2024 SUD Quarterly Metrics Report (Part A) – May to July 2023 (XLSX, 572.51 KB)
03/01/2024 SUD Quarterly Metrics Report (Part A) – February to April 2023 (XLSX, 572.22 KB)
03/01/2024 SUD Quarterly Report (Part B) – February to April 2023 (PDF, 3.89 MB)
02/28/2024 SUD Quarterly Metrics Report (Part A) – May to July 2024 (XLSX, 572.59 KB)
02/12/2024 Annual Monitoring Report – November 2022 – October 2023 (PDF, 672.39 KB)
12/22/2023 State Request to Modify Pending Foster Care Amendment (PDF, 180.65 KB)
12/01/2023 CMS Approved SUD Interim Evaluation Report (PDF, 12.97 MB)
11/29/2023 CMS Approval – Medicaid Expansion Conforming Change (PDF, 3.49 MB)
11/15/2023 CMS Completeness Letter (PDF, 265.31 KB)
10/31/2023 State Extension Application (PDF, 20.66 MB) View Comments
10/20/2023 CMS Approval – Attachment G Healthy Opportunities Pilot Eligibility and Services (PDF, 449.4 KB)
10/17/2023 State Request for Medicaid Expansion Conforming Change (PDF, 253.31 KB)
09/29/2023 Quarterly Monitoring Report – May to July 2023 (PDF, 457.59 KB)
09/28/2023 CMS Approval – Attachment H Healthy Opportunities Pilot Funding Mechanics, Pathways to Value Based Payment, and Program Integrity Protocol (PDF, 504.83 KB)
09/27/2023 CMS Temporary Extension Approval – SUD Expenditure Authority (PDF, 3.53 MB)
09/14/2023 CMS Completeness Letter (PDF, 301.25 KB)
09/11/2023 State Application – SUD Expenditure Authority Extension (PDF, 23.78 MB) View Comments
08/28/2023 CMS Approved Technical Corrections (PDF, 3.54 MB)
08/04/2023 State Acceptance Letter (PDF, 265.94 KB)
07/28/2023 SUD Quarterly Metrics Report (Part A) – November 2022 to January 2023 (XLSX, 571.43 KB)
07/28/2023 SUD Quarterly Report (Part B) – November 2022 to January 2023 (PDF, 3.85 MB)
07/07/2023 CMS Amendment Approval (PDF, 1.47 MB)
06/29/2023 CMS Incompleteness Letter (PDF, 323.69 KB)
06/29/2023 Quarterly Monitoring Report – February 2023 – April 2023 (PDF, 416.73 KB)
05/09/2023 SUD Annual Report (Part B) – May to July 2022 (PDF, 3.91 MB)
05/09/2023 SUD Quarterly Metrics Report (Part A) – May to July 2022 (XLSX, 573.12 KB)
05/01/2023 SUD Quarterly Metrics Report (Part A) – August to October 2022 (XLSX, 573.8 KB)
05/01/2023 SUD Quarterly Report (Part B) – August to October 2022 (PDF, 4.05 MB)
03/31/2023 Quarterly Monitoring Report – November 2022 – January 2023 (PDF, 477.62 KB)
03/24/2023 Healthy Opportunities Pilots Rapid Cycle Assessment (PDF, 4.84 MB)
02/06/2023 CMS Completeness Letter (PDF, 300.74 KB)
02/01/2023 Annual Monitoring Report – November 2021 – October 2022 (PDF, 792.66 KB)
01/25/2023 State Application – Foster Care Amendment (PDF, 395.9 KB) View Comments
12/28/2022 Annual Report – November 2020 – September 2021 (PDF, 613.15 KB)
11/03/2022 CMS Amendment Approval (PDF, 4.21 MB)
10/18/2022 STC Acceptance Letter and Technical Correction Request – S-CHIP Amendment (PDF, 154.89 KB)
10/07/2022 SUD Quarterly Metrics Report (Part A) – February to April 2022 (XLSX, 564.58 KB)
10/07/2022 SUD Quarterly Report (Part B) – February to April 2022 (PDF, 3.47 MB)
09/29/2022 Quarterly Monitoring Report – May 2021 – July 2022 (PDF, 604.71 KB)
09/28/2022 CMS Approval – Attachment G, Healthy Opportunities Pilots Eligibility and Services (PDF, 535.61 KB)
09/16/2022 CMS S-CHIP Initial Demonstration Approval (PDF, 16.95 MB)
08/12/2022 SUD Quarterly Report (Part B) – November 2021 to January 2022 (PDF, 3.35 MB)
08/11/2022 SUD Quarterly Metrics Report (Part A) – November 2021 to January 2022 (XLSX, 565.45 KB)
06/29/2022 Quarterly Monitoring Report - February - April 2022 (PDF, 457.84 KB)
04/29/2022 SUD Mid-Point Assessment (PDF, 2.02 MB)
04/29/2022 SUD Quarterly Metrics Report (Part A) – August to October 2021 (XLSX, 573.49 KB)
04/29/2022 SUD Quarterly Report (Part B) – August to October 2021 (PDF, 3.49 MB)
04/01/2022 Quarterly Monitoring Report – November 2023 – January 2024 (PDF, 516.54 KB)
02/28/2022 SUD Annual Report (Part B) – May to July 2021 (PDF, 3.39 MB)
02/28/2022 SUD Quarterly Metrics Report (Part A) – May to July 2021 (XLSX, 565.9 KB)
02/22/2022 CMS Completeness Letter (PDF, 309.21 KB)
01/26/2022 State Amendment Application (PDF, 1.1 MB) View Comments
10/28/2021 SUD Quarterly Metrics Report (Part A) – February to April 2021 (XLSX, 69.95 KB)
10/28/2021 SUD Quarterly Report (Part B) – February to April 2021 (PDF, 2.78 MB)
09/30/2021 Quarterly Monitoring Report - May 2021- July 2021 (PDF, 323.85 KB)
07/30/2021 SUD Quarterly Report (Part B) – November 2020 – January 2021 (PDF, 2.76 MB)
07/29/2021 SUD Quarterly Metrics Report (Part A) – November 2020 – January 2021 (XLSX, 721.93 KB)
06/28/2021 Quarterly Monitoring Report – February to April 2021 (PDF, 245.24 KB)
04/30/2021 SUD Quarterly Metrics Report (Part A) – May to July 2020 (XLSX, 557.29 KB)
04/30/2021 SUD Quarterly Report (Part B) – May to July 2020 (PDF, 2.78 MB)
04/01/2021 CMS Approved Monitoring Protocol (Part A) (XLSX, 65.56 KB)
04/01/2021 CMS Approved Monitoring Protocol (Part B) (PDF, 960.29 KB)
03/31/2021 SUD Quarterly Metrics Report (Part A) – August to October 2020 (XLSX, 664.09 KB)
03/31/2021 SUD Quarterly Report (Part B) – August to October 2020 (PDF, 302.23 KB)
03/31/2021 SUD Retrospective Quarterly Metrics Report (Part A) – November 2018 to July 2019 (XLSX, 1.51 MB)
03/31/2021 SUD Retrospective Quarterly Report (Part B) – November 2018 to July 2019 (PDF, 189.07 KB)
02/12/2021 CMS Letter to State (PDF, 38.64 KB)
09/30/2020 SUD Quarterly Metrics Report (Part A) – February 2020 to April 2020 (XLSX, 141.05 KB)
09/30/2020 SUD Quarterly Report (Part B) – February 2020 to April 2020 (PDF, 361.72 KB)
06/29/2020 SUD Quarterly Report (Part B) – November 2019 – January 2020 (PDF, 412.43 KB)
06/09/2020 SUD Quarterly Metrics Report (Part A) – November 2019 – January 2020 (XLSX, 142.37 KB)
04/01/2020 SUD Quarterly Metrics Report (Part A) – August to October 2019 (XLSX, 133.15 KB)
04/01/2020 SUD Quarterly Report (Part B) – August to October 2019 (PDF, 419.92 KB)
03/06/2020 CMS Approved SUD Monitoring Protocol (Alignment Form) (PDF, 101.27 KB)
01/15/2020 Approved Evaluation Design for NC Medicaid Reform Demonstration (PDF, 1 MB)
10/30/2019 CMS Approval: SUD Monitoring Metrics (XLSX, 140.48 KB)
10/30/2019 CMS Approval: SUD Monitoring Protocol (PDF, 623.16 KB)
08/15/2019 Approved Evaluation Design for NCMR ECM Pilot Program (PDF, 890.68 KB)
04/25/2019 CMS Approved Technical Corrections (PDF, 1.2 MB)
04/25/2019 SUD Implementation Plan Protocol (PDF, 800.86 KB)
11/20/2018 North Carolina Demonstration Acceptance Letter (PDF, 1.92 MB)
10/19/2018 Demonstration Approval (10/19/2018) (PDF, 2.67 MB)
12/05/2017 North Carolina Amended 1115 Demonstration Application (PDF, 7.73 MB) View Comments
12/04/2017 North Carolina Amended 1115 Demonstration Application Completeness Letter (PDF, 110.39 KB)
06/16/2016 CMS Completeness Letter (06/16/2016) (PDF, 106.76 KB)
06/01/2016 NC 1115 Application (6/01/16) (PDF, 10.13 MB) View Comments
Return to State Waivers List