During April 2021, Legal Aid of North Carolina initiated a new statewide project, the Medicaid Appeals Technical Team (MATT), that is tasked with serving the legal needs of the 1.7 million Medicaid beneficiaries in North Carolina who have been enrolled into Prepaid Health Plans (PHPs) during the State’s transition from a fee-for-service model of healthcare delivery to a capitated managed care model.
MATT’s inaugural work during 2021-2022 was funded by grants from the Kate B. Reynolds Charitable Trust. MATT works collaboratively with our legal and community partners in North Carolina and nationally to achieve our goals of enforcing Medicaid beneficiaries’ rights, monitoring systemic issues through our appeals work to insure that the interests of beneficiaries are centered in the State’s transition to managed care, educating community partners about beneficiary rights to insure that beneficiaries are connected to resources to address issues in a timely fashion, and bringing a health justice and equity lens to our legal advocacy work to address inequities in our healthcare system, particularly systemic barriers created by structural racism and other forms of oppression.
Advice and Consultation:
- Medicaid eligibility issues;
- Access to Medicaid services;
- Beneficiary billing issues.
Representation in State Fair Hearings:
- Denials of Medicaid eligibility and terminations of coverage;
- Denials or reductions of medically necessary care and services;
- Denials of requests to disenroll or change plans.