Provider Alert

Authorization guidelines are available on the Vaya Partners website, the Partners website, and the Vaya website. The following services delivered after Sept. 30, 2026, through Dec. 29, 2026, will not require prior authorization or admission notification: Physical Health Services Exception: Services that have Electronic Visit Verification (EVV) requirements [see section below for information about State

What is happening? Effective Oct. 1, 2026, Vaya Partners will implement the following updates to the Individual & Family Directed Supports (IFDS) Employer of Record (EOR) model: CAP/C Waiver self-directed care model transitioning to NC Innovations IFDS EOR Model: Vaya Partners offers choices to the members and families transitioning from one waiver to another. Under

As part of the Vaya Health and Partners Health Management merger, Vaya Partners will implement updates to several in lieu of service (ILOS) offerings upon plan launch on Oct. 1, 2026. Most services will continue without disruption; however, providers should review the following key operational, authorization, billing, and service updates to ensure readiness for implementation.

Vaya Health and Partners Health Management will merge to form Vaya Partners effective Oct. 1, 2026. Please review the following information about Vaya Partners rates and the rate request process.  Blended Rate Approach To determine the Vaya Partners-specific outpatient behavioral health, intellectual/developmental disability (I/DD), and traumatic brain injury (TBI) service rates to become effective Oct.

Vaya Health and Partners Health Management will merge to form Vaya Partners effective Oct. 1, 2026. Our new combined health plan brings together the strengths of both organizations to enhance access to quality care, streamline services, and support the health and well-being of the members and communities we serve. Please note the following merger guidance

The North Carolina Department of Health and Human Services (NCDHHS) has extended the deadline to submit the Provider Cost & Wage Survey until Friday, Sept. 4, 2026. The survey aims to better understand direct care workforce challenges, evaluate current reimbursement rates, and guide future workforce and rate-setting strategies. Additionally, a training session and office hours

What is happening:  NCDHHS and the North Carolina Center on the Workforce for Health have launched the Provider Cost & Wage Survey. The survey will close at 5 p.m. EST on Aug. 26, 2026.  What do providers need to do?  Provider participation is critical to ensure the analysis captures the full cost of delivering services

August 6, 2026 Partners Health Management is notifying providers of important updates related to Clinical Coverage Policy (CCP) 8F Research Based Behavioral Health Treatment (RB-BHT). NC Medicaid recently published an updated version of CCP 8F, effective Aug. 1, 2026. NC Medicaid published a bulletin on Aug. 5, 2026, highlighting changes to the policy: Updated Reminder:

Issued: July 31, 2026 Effective Aug. 1, 2026, Partners Health Management will pause accepting new provider contracting requests due to the upcoming Oct. 1, 2026, merger with Vaya Health. This applies to new requests to join the Partners network and does not apply to current providers who are asking to add sites or clinicians. Partners

Issued: July 31, 2026 Vaya Health and Partners Health Management are preparing to merge effective Oct. 1, 2026. All Partners network providers who are not currently contracted with Vaya and who are in good standing with both organizations will receive a new contract by July 31, 2026. The contract will cover all sites and Medicaid