Skip to content

Provider Alert

UM Update: Interoperability Changes Postponed to July 1, 2026

Issued: December 31, 2025 Partners Health Management is postponing changes related to the Interoperability and Prior Authorization Final Rule (CMS-0057-F) from Jan. 1, 2026, to July 1, 2026. Partners previously issued a Provider Alert on September 5, 2025  outlining the upcoming changes from the Centers for Medicare & Medicaid Services (CMS) related to the Interoperability

Provider Alert: Process for Reversing Oct. 1, 2025, Fee Schedule Cuts

Issued: December 23, 2025 As previously communicated in a Provider Alert dated Dec. 22, 2025, Partners shared information from the North Carolina Department of Health and Human Services (NCDHHS) regarding the reversal of Medicaid reimbursement rate reductions. In a follow-up communication, the Tailored Plans (all four local management entities/managed care organizations [LME/MCOs]) and Standard Plans

Provider Alert: Update: Reversal of Medicaid Reimbursement Rate Reductions

Issued: December 22, 2025 The North Carolina Department of Health and Human Services announced on Dec. 10, 2025, the reversal of Medicaid reimbursement rate reductions for NC Medicaid Direct and NC Medicaid Managed Care that took effect Oct. 1, 2025. This announcement applies to: The 3%-10% Medicaid rate reductions that took effect Oct. 1, 2025,

Provider Alert – IRIS Downtime: Wednesday, Dec. 10, 2025

Issued: December 9, 2025 Partners Health Management is issuing this Provider Alert to ensure providers are aware that the Incident Response Improvement System (IRIS) will be unavailable Wednesday, Dec. 10, 2025, from 4 p.m. to 6 p.m. to implement a system update. What is happening? IRIS will be unavailable from 4 p.m. to 6 p.m.

Provider Alert: Update: Provider Rate Reduction Implementation

Issued: December 8, 2025 In a provider alert posted Oct. 31, 2025, Partners Health Management announced it would re-adjudicate claims with a date of service Oct. 15-Oct. 31, 2025, the week of Nov. 15, 2025. This re-adjudication did not occur and has been rescheduled for the week of Jan. 12, 2026, and includes any adjudicated

Provider Alert: ProAuth Account Assistance

Issued: December 3, 2025 We are aware that some users are experiencing issues with the ProAuth website, such as the site not loading or only displaying a white screen. To resolve this, please follow the steps below: Clear your internet browser cache. Remove any old bookmarked links/URLs and update the bookmark after the site is

Provider Alert – IRIS Downtime: Monday, Dec. 1, 2025

Issued: November 26, 2025 Partners Health Management is issuing this Provider Alert to ensure providers are aware that the Incident Response Improvement System (IRIS) will be unavailable Monday, Dec. 1, 2025, from 5 a.m. to 9 a.m. to implement the Children and Family Specialty Plan. What is happening? IRIS will be unavailable from 5 a.m.

Provider Alert: Cloudflare Causing Outage for ProviderCONNECT and MemberCONNECT

Issued: November, 18 2025 Partners Health Management has learned that a Cloudflare is negatively impacting our portals, ProviderCONNECT and MemberCONNECT and ProAuth. This means providers cannot access the portals or submit authorization claims through the portals. We are actively working with our vendor to resolve this issue as quickly as possible and will keep you

Provider Alert: Utilization Management Update: Transitional Youth Services (TYS) In Lieu of Service

Issued: November 5, 2025 What is happening?   Effective Oct. 1, 2025, Partners Health Management launched a newly approved In Lieu of Service (ILOS) called Transitional Youth Services (TYS) for Tailored Plan members. This service, formerly known as Young Adults in Transition (YAT), was previously discontinued by the N.C. Department of Health and Human Services (NCDHHS).