Two of North Carolina's public managed care organizations became one on Oct. 1, 2026. Vaya Health and Partners Health Management now operate as Vaya Partners, which announced the merger that day and called itself the state's largest local management entity/managed care organization (LME/MCO), with more than 225,000 members in 47 counties.

LME/MCOs manage publicly funded services for people with mental health needs, substance use disorders, intellectual or developmental disabilities and traumatic brain injuries. Vaya Partners runs the Vaya Partners Tailored Plan and also oversees behavioral health, I/DD and TBI services for people in NC Medicaid Direct and people who use state-funded services. Vaya Health said in its May 22 announcement that state Health and Human Services Secretary Devdutta Sangvai had approved the consolidation, contingent on a successful readiness review.

What stays the same for members

NC Medicaid told county social services directors in a Sept. 10 letter that benefits and providers stay the same for Tailored Plan members, NC Medicaid Direct members and EBCI Tribal Option members served by the LME/MCO. Members were enrolled in the new plan automatically and can keep seeing their current providers. The letter calls the merger "mainly a name change" and says no action is needed to keep current services.

Vaya Partners was to mail welcome packets by Sept. 17. Tailored Plan members get a new member ID card in that packet, and NC FAST mails new cards to people in NC Medicaid Direct. NC Medicaid asks members to use the new cards at appointments and at the pharmacy.

What changes for providers

  • Claims. Vaya Partners says it has moved claims processing onto one platform, the Conduent HSP system Vaya already used. A Sept. 10 Vaya provider bulletin says claims for dates of service on or after Oct. 1 go to Vaya Partners under payer ID 13010. Claims for earlier dates follow the old Vaya or Partners process; Partners behavioral health claims for those dates keep payer ID 13141.
  • Rates. The same bulletin says Vaya Partners' standard rate schedules took effect Oct. 1 for the whole network, including the NC Innovations Waiver schedule, which adds a blended rate for crisis intervention and stabilization supports (H2011YZ). The schedules and a procedure code crosswalk are posted on VayaPartners.org.
  • Electronic visit verification. Partners' EVV guidance says Partners authorizations were reissued in the Vaya Partners HHAeXchange portal before Oct. 1. Claims for former Partners members with dates of service before Oct. 1 can still be filed through the Partners HHAeXchange portal until March 31, 2028.
  • Prior authorizations. The merger announcement says Vaya Partners has guaranteed 90-day flexibilities for prior authorizations to support continuity of care.

The combined organization is led by Tracy Hayes, who led Vaya Health, as area director and CEO. Former Partners CEO Libby McCraw is senior deputy CEO and chief operating officer, and Rachel Porter is deputy CEO. A 28-member board draws on both organizations' former boards.

Why this matters for providers and DSPs

For provider agencies that served people through Partners, Oct. 1 changed the payer ID, the rate schedule and the EVV portal for new dates of service. Billing staff should check that systems, including HHAeXchange, carry the new information, since the bulletin reminds providers to bill at or above the posted rates to receive full unit reimbursement. Former Partners claims for earlier dates still follow the old process.

For DSPs and the people they support, the state says services and providers continue as before. The practical change is the new ID card, which people should bring to appointments and the pharmacy.