PHPs are required to provide drug coverage to Medicaid beneficiaries consistent with the drug coverage determined by NC Medicaid under fee for service.
Topics Related to Bulletins
Taxonomy codes must be included when submitting claims to prepaid health plans
Ensure compliance with the HCBS final rule and prepare Tailored Plans and Providers for the launch of Tailored Care Management.
Effective with date of service July 1, 2021, the Medicaid and NC Health Choice cover bupivacaine and meloxicam extended-release solution.
Effective with date of service June 28, 2021, the Medicaid and NC Health Choice programs cover dasiglucagon injection, for subcutaneous use (Zegalogue®)
Effective with date of service July 15, 2021, Medicaid and NC Health Choice cover asparaginase erwinia chrysanthemi (recombinant)-rywn injection, for intramuscular use (Rylaze™)
Effective with date of service July 8, 2021, the Medicaid and NC Health Choice programs cover oritavancin for injection, for intravenous use.
To assist providers in navigating the managed care health plans' PCS referral and intake process, NC Medicaid has partnered with the health plans to implement a short-term solution for ACH providers who deliver PCS services.
May be available for those at risk of not meeting financial obligations