Topics Related to Division of Health Benefits

The sterilization consent form found on the U.S. Department of Health & Human Services website has been updated.
Effective Dec. 1, 2022, Medicaid and NC Health Choice cover teplizumab-mzwv injection.
Effective Nov. 16, 2022, Medicaid and NC Health Choice cover tremelimumab-actl injection.
Effective Dec. 15, 2022, Medicaid and NC Health Choice cover mirvetuximab soravtansine-gynx injection.
The federal fee for Medicaid enrollment has increased to $688 for calendar year 2023.
Claims submitted to a health plan have a timely filing claims processing deadline of 180 calendar days
Policy updates for NC Medicaid Direct beneficiaries in the Obstetrical Services and Pregnancy Management Program policies, retroactive to Jan. 1.
Note: This bulletin is replaced by NC Health Choice Move to Medicaid: Timeline for Claims Adjudication and Process for Prior Approvals.
This document provides guidance on what capacity building funds can be used for as well as the timeframes for use of the funds.
NC Medicaid is implementing new Managed Care Nursing Facility rates to support nursing facility providers and NC Medicaid members.