The adjudication of some prior approvals will be performed by GDIT Fiscal Agent Operations Reviewers instead of clinical reviewers at NC Medicaid
Topics Related to Division of Health Benefits
Service field location effective date change from Oct. 5, 2022, to Jan. 1, 2023
NC Medicaid is working with Standard Plans to create easier pathways for providers to reach Standard Plans and resolve panel issues.
Effective July 1, 2022, Medicaid and NC Health Choice cover kit for the preparation of Gallium Ga 68 gozetotide injection
Provider manual update, guidance on position qualifications, phased assignment approach for Tailored Care Management providers and more.
NC Medicaid is sharing a list of member counts for Advanced Medical Home practices affiliated with Tailored Plans
Effective June 22, 2022, Medicaid and NC Health Choice cover Nalmefene hydrochloride injection (Revex™)
Effective June 22, 2022, Medicaid and NC Health Choice cover Risankizumab-rzaa Injection, for intravenous use (Skyrizi).
Effective June 21, 2022, Medicaid and NC Health Choice cover Vutrisiran injection, for subcutaneous use (Amvuttra).
The PDAP Medicaid fee schedule requires multiple rate updates