Topics Related to Division of Health Benefits

Specialty Care Referrals in NC Medicaid Reminder: NC Medicaid does not require referrals for specialty care.

This bulletin provides information about referrals for specialty care for NC Medicaid beneficiaries.

Skilled Nursing Facility Provider Tax Rates, Final CMI Resident Rosters, and Interim/Temporary Rate Increase Update

This bulletin provides updates on NC Medicaid’s Skilled Nursing Facility (SNF) reimbursement program.

Health Information Exchange Reminder

All providers who have not yet connected are encouraged to sign a Participation Agreement and participate in the onboarding process.

CMS Approves New Flexibilities for the NC Medicaid Reform Section 1115 Demonstration Project

Includes flexibilities related to Tailored Plans and Healthy Opportunities Pilots

Expanded NCTracks Contacts for Optical Providers

Provides information for providers of beneficiaries enrolled in NC Medicaid Direct and NC Medicaid Managed Care

2022 Consumer Assessment of Healthcare Providers and Systems Report Available

This patient experience survey serves as a national standard for measuring and reporting respondents’ experiences with their health care.

Donation of Abandoned Long-Acting Injectable Antipsychotics to a Registered Drug Repository Program

Clinical Coverage Pharmacy Policy 9 will allow for donation of abandoned Long-Acting Injectable Antipsychotics to a registered Drug Repository Program

NC Medicaid Planning for October 1 Medicaid Expansion Launch

With state budget negotiations ongoing, NCDHHS has worked with CMS to negotiate a compromise to begin submitting documents needed for federal approval to launch Medicaid expansion on October 1, 2023.

SPECIAL BULLETIN COVID-19 #269: Extension of Temporary/Interim Rates Through August 31, 2023

NC Medicaid is continuing the extension of the temporary/interim estimated legislative rate increases.

NC Medicaid Managed Care Provider Update – July 20, 2023

Includes provider recredentialing/reverification, billing requirement modifications, Tailored Plan implementation, upcoming key milestones, playbook updates and more.