Provider Alert

Vaya Health and Partners Health Management will merge Oct. 1, 2026, to form Vaya Partners. Updated select standard rates for all behavioral health Medicaid and non-Medicaid (State-funded) services are now posted on the Vaya Partners website at VayaPartners.org. They are also accessible through Vaya’s Rate and Checkwrite Schedules webpage and the Partners Claim and Rates

Partners Health Management wants providers to be aware of the process for contacting Eligibility and Enrollment ahead of its pending merger with Vaya Health on Oct. 1, 2026. Providers should use the designated Eligibility and Enrollment (E&E) support lines and contact information below, rather than calling E&E staff on their direct phone lines. This will

The Utilization Management Provider Portal Authorizations training scheduled for 1-2 p.m. today, Sept. 24, 2026, has been cancelled. We apologize for any inconvenience. Please refer to the Vaya Partners ProviderCONNECT portal training schedule below, which will continue throughout October. For more information, email provider.training@vayahealth.com.   General Provider Portal Overview and Navigation: Tuesdays, 1-2 p.m. –

Effective Oct. 1, 2026   Vaya Health and Partners Health Management will merge to form Vaya Partners on Oct. 1, 2026. At that time the following changes will be effective. CAP Waiver self-directed care models transitioning to NC Innovations Individual & Family Directed Supports (IFDS) Employer of Record Model (EOR) Vaya Partners offers choices to

Effective Oct. 1, 2026 The NC Innovations Waiver requires that Care Managers monitor implementation of the member’s care plan / individual support plan, using a standardized monitoring check list. When Vaya Health and Partners Health Management merge on Oct. 1, 2026, to form Vaya Partners, NC Innovations Waiver providers will experience changes in submitting quarterly

Partners Health Management is notifying providers of updates to NC Medicaid Clinical Coverage Policy (CCP) 8G: Peer Support Services, which became effective Sept. 1, 2026. NC Medicaid has published a revised version of the policy that includes updates to the service definition, eligibility and medical necessity criteria, authorization requirements, service orders, documentation standards, provider responsibilities,

In preparation for the upcoming Oct. 1, 2026, merger of Vaya Health and Partners Health Management (Partners), Tailored Plan and NC Medicaid Direct member eligibility has changed in NCTracks to Vaya Partners. This change is resulting in providers receiving invalid eligibility messages when trying to enter authorization requests in ProAuth for dates of service beginning

Starting Oct. 1, 2026, some members will see a difference in how pharmacy copays are applied. This change is to align and be consistent with North Carolina’s Medicaid copay rules. As a result, some  members with an intellectual/developmental disability (I/DD) will have a $4 copay when they fill a prescription. Not every member with I/DD

Vaya Partners’ standard rate schedules will go into effect Oct. 1, 2026, for the entire Vaya Partners network. Rate schedules and a procedure codes crosswalk are posted to the new Vaya Partners website at VayaPartners.org. Please note the following schedules have been updated: Medicaid Clinician Services, Medicaid 1915(c) NC Innovations Waiver, and Non-Medicaid (State-funded) Clinician Services.

The 2026 MH/SUD Client Perceptions of Care Survey closes Sept. 18, 2026. All surveys are required to be submitted electronically via the appropriate link for the member’s population (Adult, Youth, Child/Family). Spanish versions are also available.  What is happening?  Partners Health Management is requesting providers of mental health and substance use disorder services (MH/SUD) to