March 1, 2024 Edition 8

The monthly Provider Insider Newsletter will differ from the Network Communication Bulletins by offering an avenue to highlight community happenings across our catchment area. We will share information on various projects Trillium is working on within our local communities and introduce new skill development/training opportunities available to providers.

• Provider Spotlight: Peer Recovery 365 LLC
• Consolidation Updates
• Provider News
• Community Involvement
• Provider Resources
• New Opportunities
• Provider Knowledge
• In Case You Missed It 

Peer Recovery 365 LLC is a first of its kind in Eastern NC peer-led and run mental health agency using professional training/education & personal lived experience to support others on their journeys.

The mission of Peer Recovery 365 LLC is to improve the mental health and well-being of those struggling with mental and addictive disorders through counseling, education, support, and advocacy and focusing on the Eight Dimensions of Wellness: emotional, financial, social, spiritual, occupational, physical, intellectual, and environmental.

Services offered by Peer Recovery 365 LLC:

• Peer Support
• Individual Placement Services-Support Employment
• Transitional Management Services
• Substance Abuse Intensive Outpatient Program (SAIOP)
• Substance Abuse Comprehensive Outpatient Program (SACOT)
• Outpatient Therapy
• Diagnostic/Mental Health Assessments
• Medication Management

Peer Recovery 365 LLC currently serves Edgecombe, Nash, Pitt, Sampson, Duplin, Pender, Onslow, Robeson, Wilson, Wayne, Halifax, & Bertie counties, and is steadily growing. Services are offered via telehealth and in-person visits.

For more information, please contact Peer Recovery 365 LLC by calling 910-226-8282 or by email.

If you or a fellow provider are interested in sharing your story, please contact us at info@trilliumnc.org. Thank you for all you do for our members!



Consolidation Updates

Trillium remains committed to supporting members, providers, and stakeholders after consolidation with Eastpointe and Sandhills Center.

Trillium's Consolidation page continues to be available with updates, recent communications, resources, documents, and helpful links.

Providers are encouraged to submit all questions to Trillium's Network Service Ticket System using the email address NetworkServicesSupport@TrilliumNC.org, as submitting questions through the previous Questions link is no longer available.

The Centers for Medicare & Medicaid Services (CMS) is mailing letters to 534,840 North Carolinians based on information provided to HealthCare.gov that indicates they may be eligible for NC Medicaid. With the expansion of Medicaid, more people are eligible, including those ages 19 through 64 years with higher incomes.

The letters will arrive in mailboxes on or after Feb. 1, 2024, and will direct individuals to contact HealthCare.gov to update their information currently available in their HealthCare.gov case file. Sample letters are available on the Medicaid website.

NC Medicaid began accepting Federally-facilitated Marketplace Eligibility Determinations (FFM-D) on Feb. 1, 2024. This change allows the FFM to make the eligibility determination for individuals who apply for coverage through the Federal Marketplace at HealthCare.gov and whose eligibility is determined following modified adjusted gross income (MAGI) rules.

This change means NC residents who apply for Medicaid through the Federal Marketplace (HealthCare.gov) and are determined fully eligible for Medicaid by the FFM will no longer require an eligibility determination by the local Department of Social Services (DSS) caseworker. Once NC Medicaid receives notification of eligibility, NC FAST will review the case to determine which full MAGI benefit program the individual qualifies for and will send the appropriate final notice of eligibility to the individual.

For more information, visit HealthCare.gov.

The Department of Health and Human Services will launch the Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plans on July 1, 2024.

Beneficiaries who will be covered by the Tailored Plans will continue to receive behavioral health, I/DD, TBI and physical health care as they do today. 

Trillium Health Resources will launch its Behavioral Health Intellectual/ Developmental Disability (I/DD) Tailored Plan to serve members and recipients in our region. Tailored Plans will coordinate integrated services for physical and behavioral health care needs.

Behavioral Health I/DD Tailored Plans are specifically designed to serve the complex needs of individuals with significant behavioral health disorders, intellectual and developmental disabilities, and traumatic brain injury — populations Trillium and all other LME/MCOs have long served. The Tailored Plans will also serve uninsured individuals currently receiving state-funded services, regardless of their diagnosis, along with those remaining in Medicaid Direct.

Read More Here



The North Carolina Department of Health and Human Services is launching a new Statewide Peer Warmline on Feb. 20, 2024. The new Peer Warmline will work in tandem with the North Carolina 988 Suicide and Crisis Lifeline by giving callers the option to speak with a Peer Support Specialist. Peer Support Specialists (or “peers”) are people living in recovery with mental illness and/or substance use disorder who provide support to others who can benefit from their lived experience.

The statewide Peer Warmline is a phone line staffed by Peer Support Specialists who offer non-clinical support and resources to those in crisis. Their unique expertise helps reduce stigma while strengthening overall engagement in care. Like 988, North Carolina’s peer warmline is available 24 hours a day, 7 days a week.

Starting Tuesday, Feb. 20, 2024, people in need of assistance and wanting to speak with a peer can call the warmline at 1-855-PEERS NC (1-855-733-7762), and people who call 988 will have the option to connect with the Peer Warmline if they prefer to speak with a peer.

The statewide Peer Warmline will be run by the Promise Resource Network (PRN), a peer-run organization in Mecklenburg County. PRN was awarded the contract following a competitive public bidding process. 

Press Release



Trillium hosts African American Health Summit

On February 20, Trillium hosted an African American Health Summit in New Bern, NC. It was open to the public, with a great turnout for the event.

The speakers brought important information with the intent of educating the audience about diseases and health issues that impact the African American community. Dr. LaDonna Battle, Executive Vice President & Population Health Office at Trillium, used her background in women’s health nursing to speak about the mortality rate in pregnancy and childbirth. Chelsea Rivenbark, FNP-C, who practices at ECU Health in hematology, brought her expertise in working with Sickle Cell Anemia. Dr. Portia Pope who is the Deputy Director of the Office of Health Equity and Community Engagement with the NC Department of Health and Human Services, spoke about the mental health service disparities that the State of North Carolina faces. The Summit was rounded out with information about heart health and disease presented by Taskeen Midgett, AGNP-C. Ms. Midgett is a Nurse Practitioner that practices at a local New Bern private practice specializing in heart and vascular specialty.

The program also included a panel discussion where the audience was able to present questions of the speaker.



Crystal Coast Run/Walk for Autism

As many as 1 in 36 children may be diagnosed with autism in North Carolina. Make a difference in the lives of children with autism and their families by registering for the Crystal Coast Run/Walk for Autism.

Registration is $30, but make an even bigger impact by recruiting family members, friends, and co-workers to form a team and raise donations — now is the time to start!

Proceeds from the Crystal Coast Run/Walk for Autism will fund local programs of the Autism Society of North Carolina (ASNC), the leading statewide resource organization serving kids and adults with autism and their families. Everyone knows someone affected by autism — maybe your brother, cousin, friend at school, neighbor, or co-worker.

The Crystal Coast Run/Walk for Autism will have something for everyone! Join the Autism Society of North Carolina for the 5K noncompetitive run or the family friendly recreational 1-mile run/walk.

The Crystal Coast Run/Walk for Autism will take place on March 23, 2024 at the Beaufort Waterfront in Beaufort, NC. Check-in is at 8:00AM and the 5k begins at 9:00AM.

If you have questions, call 800-442-2762, ext. 1101, or visit the event website.



Provider Resources

This is a reminder to Trillium providers that disaster plans need to be reviewed and updated, staff trained/re-trained, and contingency and communication plans developed.

For 2024 disaster plan submission you will go to a link to share your 2024 Disaster Plan and important contact information. 

This requested information includes:

• Contact information for your designated “Disaster Point of Contact”
• Corporate site address and facility phone number
• Any residential sites currently in your contract (address, phone numbers)

Please note, you will need to enter each site as a separate submission. Disaster plans must be submitted here.

Disaster Plans are due no later than May 1, 2024. If no updates are needed to your 2024 Disaster Plan, you must still resubmit the plan with a new cover page displaying the current year and disaster contact info. To confirm your disaster plan was received just check the "send me a copy of my responses" option at the end of the Disaster Plan Submission form. Failure to submit your Disaster Plan for 2024 by the deadline (May 1, 2024), may result in an audit and/or plan of correction.

The Federal Center for Medicare and Medicaid Services (CMS) posted guideline requirements for all entities that receive Medicaid funds and this applies to all of our Medicaid providers. For your reference, we have attached the Final Rule that will assist you in locating the requirements to the federal rules that apply to each of your situations.

Our contract with providers requires that you have an adequate disaster planning and training process in place within your organization. While it is our desire that no one has to contend with all that a hurricane or flood brings, the reality is that North Carolina has dealt with its fair share of these kinds of disasters in the past. We know that the best way to cope when a disaster strikes is preparation. Please connect with your local emergency management services, know your local resources, and stay connected with Trillium in the event of an emergency.

In addition, Trillium has a list of disaster preparedness resources listed on our website.

Please email Sarah Hartz or call Trillium's Provider Support Service Line: 1-855-250-1539 for assistance.



Read More Here

Trillium EthicsPoint

EthicsPoint is a secure and confidential system available 24 hours a day, 7 days a week for anyone to report suspected violations of potential fraud, waste and abuse, or confidentiality incidents. You can access EthicsPoint through website submission at EthicsPoint—Trillium Health Resources or by calling toll free 1-855-659-7660.



The NC Innovations Waiver is a federally approved 1915(c) Medicaid Home and Community-Based Services (HCBS) Waiver designed to meet the needs of individuals with Intellectual or Developmental Disabilities (I/DD) who prefer to get long-term care services and supports in their home or community instead of in an institutional setting.

NC Medicaid has established standard documents that LME/MCOs can use as part of a process to enable eligible Medicaid providers to meet legislative requirements for participation in the Innovations Waiver Services provider rate increase. This provider rate increase is intended to fund Innovations Waiver Service Direct Care Worker (DCW) wage increases.

As outlined in Section 9E.15 of the Session Law, in order to obtain the rate increase, an authorized user for each eligible Innovations Waiver Service provider must complete and submit to their Local Management Entity/Managed Care Organization (LME/MCO) an Innovations DCW Wage Increase Attestation and Acknowledgment Form.

Read Fact Sheet

New Opportunities

Trillium's Training Department will be offering multiple trainings focused on cultural competency, diversity, equity, and inclusion (DEI), and bias for providers.



Learn More Here

Register Here



Provider Knowledge

Early and Periodic Screening, Diagnosis and Treatment (EPSDT) is the federal law that says Medicaid must provide all medically necessary health care services to Medicaid-eligible children. Even if a service is not covered under the North Carolina Medicaid State Plan, it can be covered for members under age 21 if the service is listed at 1905(a) of the Social Security Act and if all EPSDT criteria are met.

Trillium is committed to providing preventive health screenings and improving the overall health of children enrolled in our health plans. Trillium will cover services, products, or procedures for a Medicaid member under age 21 if the service is medically necessary to correct or ameliorate a defect, physical or mental illness, or a condition or health problem identified through a screening examination.



Learn More Here



Providers are responsible for safeguarding a member's protected health information (PHI) when transmitting PHI. A secure method of transmittal should be utilized when sending PHI electronically which can be accomplished through encryption software. Your agency may have a specific software platform or Trillium offers providers the opportunity to create and securely send emails by accessing Zixmail in the Provider Portal on Trillium's website.

Zixmail will encrypt the contents and attachments of the email. It does not however, encrypt information in the subject line. No form of PHI should be included in the subject line of an email. When sending PHI to Trillium or other agencies through email or ticket submission, please ensure you are utilizing a secure method of transmittal to eliminate any potential confidentiality concerns. Zixmail Instructions are available on Trillium's website, under "IT Information and Forms."

Read More Here



New Medicaid Expansion Enrollment Dashboard, Updated Monthly with Enrollee Data

The North Carolina Department of Health and Human Services launched a dashboard to track monthly enrollment in Medicaid for people eligible through expansion.

More than 600,000 North Carolinians are newly eligible for health coverage.

Re-verification Requirement

You should have received a Re-verification Notification from NCTracks. If you have not responded, please act now. If you do not submit the re-verification application and pay the application fee by the due date, your Medicaid claims will not be paid.

Network Communication Bulletins 2023

Click above for more information.

Have Questions/Need Support?

If you have questions, need additional information, or require technical assistance, please contact our Network Management Department at NetworkServicesSupport@TrilliumNC.org or call Provider Support Services at 1-855-250-1539 during the hours of 7 a.m.–6 p.m. EST, Monday–Saturday. 

We appreciate your commitment to helping us achieve this mission by meeting the needs of members!

Provider Insider is a newsletter for the Trillium Health Resources provider community. Please send comments and suggestions about this publication and its contents to NetworkServicesSupport@TrilliumNC.org.