Issued: June 9,2025
The proposed state budgets from the North Carolina House and Senate do not include funding to continue the Healthy Opportunities Pilot (HOP) services after June 30, 2025. Partners Health Management is notifying HOP agencies and recipients that services must stop by July 1, 2025. If funding is restored in the final state budget, the North Carolina Department of Health and Human Services (NCDHHS) is prepared to resume HOP services.
Partners will stop accepting new HOP enrollments and new HOP authorizations as of 5 p.m., Monday, June 9, 2025.
Background:
As part of NC Managed Care, North Carolina offered the HOP program in designated counties starting in 2022. Partners’ pilot counties are Burke and Rutherford. The HOP program is the nation’s first comprehensive program to help members overcome non-medical barriers to health by providing select evidence-based, non-medical interventions related to housing, food, transportation, and interpersonal safety and toxic stress.
What is happening?
- HOP services will end June 30, 2025, unless the state restores funding for the program in its proposed budget.
- Partners will stop accepting new HOP enrollments and authorizations as of 5 p.m. Monday June 9, 2025.
- Current HOP authorizations will end at their expiration or the end of the day on Monday, June 30, 2025, whichever occurs first.
- For current authorizations that extend beyond June 30, 2025 services will end no later than June 30, 2025.
What do providers need to do?
- Providers should not request any new enrollments or authorizations for HOP services.
- Providers must end current HOP services by the end of the day on Monday, June 30, 2025, or by the authorization service date if that date is before June 30.
- Providers must end current authorizations on June 30, even if the authorization runs beyond that date.
What do members need to know?
- Members receiving HOP services will no longer receive those services after June 30, 2025.
- Partners will notify members receiving HOP services at least 10 days prior to stopping the services.
- Even though the HOP services are no longer available, Partners will continue to assist members with essential non-medical resources to ensure their health needs are met. Since 2012, as a Local Management Entity/Managed Care Organization (LME/MCO), Partners has served our members by working closely with community-based agencies in our counties to make sure they get the services and supports they need. Partners will continue to assist members with community resources.
Who can providers and members contact if they have questions?
- If members have questions, they can contact their care manager or email HOP@PartnersBHM.org.
- Members may also call Partners’ Member and Recipient Services Line at 1-888-235-4673.
- Providers can contact their account specialist or email PAS@PartnersBHM.org.
- Providers may also call the Provider Service Line at 1-877-398-4145.