Topics Related to Division of Health Benefits

This report describes findings from the second assessment of provider experience and satisfaction with the NC Medicaid program.
Beginning with date of service May 12, 2023, NC Medicaid will end temporary emergency flexibilities implemented for three claims processing edits.
This bulletin has been replaced by Provider Reverification Process Update - March 15, 2023.
The rates for HHCS shall be increased by 10% above the current fee schedule rate.
Clinical Coverage Policy 8A, Mobile Crisis Management
Implementation of Tailored Plans Start Date Oct. 1, 2023
Effective Dec. 7, 2022, Medicaid and NC Health Choice cover bendamustine hydrochloride injection, for intravenous use (Vivimusta).
Effective Jan. 9, 2023, Medicaid and NC Health Choice cover mosunetuzumab-axgb injection, for intravenous use (Lunsumio).
Optum has been awarded a contract to implement the solution, scheduled to launch in 2024.
NC Medicaid reimburses qualified providers for medically necessary circumcision for newborns and non-newborns.