Categorical Risk Level Subject to Bump-Up for Certain Providers.
Blog Entry List
Effective July 24, 2026, Basaglar® U-100 KwikPen® moved to Preferred status due to reported shortage of Lantus SoloStar pen.
This bulletin replaces in full the December 2025 Utilization Management by Managed Care Plans Aligned with Food and Drug Administration Labeling bulletin.
Reminders for NC Medicaid Managed Care, NC Medicaid Direct and Medicare.
The revised NC Medicaid 1915(i) assessment must be used starting Oct. 1, 2026, and includes a new companion guide.
This bulletin reflects revised effective dates and applies to all research‑based behavioral health treatment providers in NC Medicaid Managed Care and NC Medicaid Direct.
This Medicaid bulletin replaces in full the July 31, 2026, Rate Increase for Personal Care Services and the Community Alternatives Program bulletin.
This Medicaid Bulletin has been completely replaced by an updated version published on Aug. 4, 2026. Please see the Updates to Rate Increase for Personal Care Services and the Community Alternatives Program bulletin, for the latest information.
NC Medicaid, in collaboration with the four NC Medicaid Managed Care Standard Plans, will host the Sixth Annual Virtual Statewide Quality Forum on Wednesday, Oct. 14, 2026, from 11 a.m. to 1 p.m.
The updated fax number is effective as of July 15, 2026. This bulletin applies to NC Medicaid Direct.
Amendments to Clinical Coverage Policy 1A-20, expanding medical necessity criteria and updating coverage for sleep studies and polysomnography services are effective July 1, 2026.
This bulletin applies to all research-based behavioral health treatment providers in NC Medicaid Managed Care and NC Medicaid Direct.
For eligible individuals, NC Medicaid will now pay for Family Planning services in addition to Medicare premiums and cost sharing.
Care Management rate considerations effective July 1, 2026.
Impacted NC Medicaid providers will be included in the Active Provider Reverification Report, and notifications with specific deadlines are expected by the end of September 2026.