Trillium Single Case Agreement


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There is no other law or rule requiring a supplier to use an MCO`s internal audit process before filing an application for a contentious matter. There is a reason why I insist on the letterhead. This is because DHHS withdraws contracts with a number of suppliers. For example, DHHS contracts with public Consulting Group (PCG), Carolina Center for Medical Excellence (CCME), HMS, Liberty, etc. They might receive a letter from one of DHHS`s contractors – a letter on their letterhead. For example, you might receive a preliminary notice about overpayment on the PCG letterhead. In this case, PCG is acting on behalf of DHHS. The informal review rules would therefore be the same. In contrast, for MCOs, we have received a waiver from the Center for Medicare and Medicaid Services (CMS) to “waive” certain rules and create MCOs.

MCOs are subject to different rules than those applicable to DHHS. In fact, there is an argument that N.C. gene. Stat.. .

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