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Home  •  Waiver & Medicaid Services  •  Innovations  •  What is the NC Innovations Waiver?

Innovations Waiver


What is the NC Innovations Waiver?

The NC Innovations Waiver is a federally-approved 1915(c) Medicaid Home and Community-Based Services Waiver (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, rather than in an institutional setting. The NC Innovations Waiver provides supports for individuals with I/DD to live the life they choose. Individuals who receive waiver funding work with their team to develop a person-centered plan of care to request the services and supports they need. 

Waiver services are administered by a county-specific local management entity/managed care organization (LME/MCO) that facilitates services and oversees a network of community-based service providers. Each county chooses their LME/MCO. The number of waiver slots are also allotted per county by the General Assembly, based on population and need, and, as a result, some counties have longer waiting lists than others. The Centers for Medicare and Medicaid Services (CMS) approves the services provided under NC Innovations, the number of beneficiaries that may participate each year, and other aspects of the program. The waiver can be amended at any time with CMS approval. CMS may exercise its authority to terminate the waiver, whenever it believes the waiver is not being operated properly. NC Medicaid operates the NC Innovations Waiver and contracts with the LME/MCOs to manage the delivery of services and perform other waiver operational functions under the concurrent 1915(b)(c) waivers. NC Medicaid directly oversees the NC Innovations Waiver, approves all policies and procedures governing waiver operations, and ensures that the NC Innovations Waiver assurances are met. The current waiver was approved effective July 1, 2019, for five years, through June 30, 2024. Details regarding the services, procedures, and policy can be found here: NC Innovations Waiver Clinical Coverage Policy.