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NC Department of Health and Human Services
NC Division of
Medical Assistance

Community Alternatives Program (CAP)

DMA Clinical Policy and Programs
Phone Number 919-855-4340
Fax 919-715-9025

Expiration of 30-Day Public Comments Period for Combined CAP/C and CAP/DA Waivers

The 30-day public posting of the CAP Waiver ended on September 28, 2015. All comments, questions and recommendations from the public posting will be carefully reviewed and considered for incorporation into the waiver. After the review of the comments and recommendations is completed, Division of Medicaid Assistance (DMA) will submit the waiver to the Centers for Medicare & Medicaid Services (CMS) for review and approval. DMA anticipates the approval of the waiver by December 2015 with a retro-active waiver effective date of January 1, 2015.

Until the waiver is approved by CMS, current waiver practices and procedures will remain in place; continue to follow the guidelines, policies and directives of your current waiver.

What is a Waiver

North Carolina operates several programs to provide home and community care as a cost-effective alternative to institutionalization. These are known as "waiver" programs because standard program requirements are waived to allow the program to operate. These waiver programs provide some services that otherwise are not covered under Medicaid.

Overall, the CAP programs have been very successful in giving individuals a choice and maintaining costs at the same time. The programs have allowed those who otherwise would be institutionalized to remain with their family in familiar surroundings. All of these benefits accrued at a cost-saving to Medicaid in comparison with the cost of institutional care.

Medicaid Bulletins

For changes and updates to coverage criteria, billing information, and other program requirements refer to the N.C. Medicaid general and special bulletins. Ready NC Connect NC