Topics Related to Bulletins

NCDHHS Consolidates Local Management Entity/Managed Care Organizations Ahead of Tailored Plan Launch

Eastpointe and Trillium Health Resources have consolidated into one entity, and Sandhills Center has dissolved.

NC Medicaid Guidance on Sunsetting of Traumatic Brain Injury Appendix K Flexibilities

Permanent flexibilities approved in the TBI Waiver amendment effective March 1, 2024.

NC Medicaid Managed Care Provider Update – Jan. 30, 2024

Includes information on LME/MCO consolidation, Innovations and TBI waivers, federal fee increase, updates to NCTracks, Medicaid expansion and more.

NC Managed Care Capitation Rates – Updated Care Management Assumptions for Expansion Population

Includes rate considerations for Medicaid Expansion members effective Dec. 1, 2023.

NC Medicaid Guidance on Sunsetting of Innovations Waiver Appendix K Flexibilities

Permanent flexibilities approved in the Innovations Waiver amendment effective March 1, 2024.

Over-the-Counter COVID-19 Test for Home Use Pharmacy POS Coverage

CorDx, GoToKnow, FaStep COVID-19 AG Home Tests added to coverage.

Electronic Visit Verification for NC Medicaid-Funded Personal Care Services and Home Health Services

Manual entries and Sandata Mobile Connect 2.0.

Quality of Care Fact Sheets Available

Fact sheets provide key findings, trends, improvements and new programs

New Exclusion Sanction Questions to be added to Applications for Provider Enrollment

Beginning Jan. 28, 2024, five new additional exclusion sanction questions will be added.

Additional NC Medicaid Respiratory Syncytial Virus (RSV) Guidelines for 2023-2024

This bulletin replaces the NC Medicaid Respiratory Syncytial Virus (RSV) Guidelines for 2023-2024 - Revised published Nov. 3, 2023.