Topics Related to Division of Health Benefits
The North Carolina Department of Health and Human Services (NCDHHS), through General Dynamics Information Technology, Inc. (GDIT), will establish a Credentialing Committee to review files that contain flagged items for disposition of their enrollment, reenrollment and recredentialing applications and issues discovered through ongoing monitoring. This will apply to all providers enrolling with:
Information on Provider Ombudsman, Children and Families Specialty Plan and Upcoming Credentialing Changes.
The Tailored Care Management payment rate is $294.86 effective July 1, 2025.
Effective July 1, 2025, NC Medicaid adjusted the provider assessment rates.
The strategy outlines visions and goals for NC Medicaid Managed Care for the next three years.
NCDHHS is pleased to announce the release of the 2021-2023 NC Medicaid Annual Quality Report.
NC Medicaid has released a new online tool for beneficiaries to compare the five available Standard Plans. The 2025 NC Medicaid Standard Plan Performance Comparison Tool is now available online.
NC Medicaid Guidance on Sunsetting of Community Alternatives Program Waiver Appendix K Flexibilities
NC Medicaid Hurricane Helene flexibilities for Community Alternatives Program for Children (CAP/C) and Community Alternatives Program for Disabled Adults (CAP/DA) Waiver programs will expire on June 30, 2025.
NCTracks will implement system enhancements to improve the processing of Private Duty Nursing (PDN) Prior Approvals (PAs) and claims.
Updated guidance for forms NC Medicaid 372-124 and DMA-0100.