Hospital at Home Program Re-Launch: NC Medicaid will cover the Acute Hospital at Home Program starting Nov. 1, 2023.
NOTE: This Bulletin was revised on April 2, 2024 to correct an error. In the original version, published Sept. 27, 2023, it was stated that the Hospital at Home Program had a previous end date of March 31, 2021. Prior to relaunch, the previous end date was March 31, 2022, as corrected and explained below.
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Effective Oct. 1, 2023, copays will no longer be required for adult vaccines and vaccine administration.
Cards are only allowed to be used exclusively for the member’s individual needs.
Clinical Coverage Policy 8A, Enhanced Mental Health and Substance Abuse Services and 8C, Outpatient Behavioral Health Services
More than 600,000 people will gain access to quality care.
The 2024 ICD-10 update is effective Oct. 1, 2023 through Sept. 30, 2024.
Claims without the required EVV data will be denied.
Nursing Facility Providers and Intermediate Care Facilities for Individuals with Intellectual Disabilities Targeted.
COVID-19 OTC Tests for home use are covered for full Medicaid enrollees through Sept. 30, 2024. Guidance for NC Medicaid coverage and the complete list of covered products are available on the Outpatient Pharmacy Services webpage. Updates to the covered products are below.
Vaccine strains for the 2023–24 influenza vaccines were selected by the Food and Drug Administration’s Vaccines and Related Biologic Products Advisory Committee based on WHO’s recommended Northern Hemisphere 2023–24 influenza vaccine composition. For details on the 2023-2024 influenza vaccines, visit the Centers for Disease Control (CDC) Flu Season web page.
Vaccine strains for the 2023–24 influenza vaccines were selected by the Food and Drug Administration’s Vaccines and Related Biologic Products Advisory Committee based on WHO’s recommended Northern Hemisphere 2023–24 influenza vaccine composition. For details on the 2023-2024 influenza vaccines, visit the Centers for Disease Control (CDC) Flu Season web page.
The North Carolina Department of Health and Human Services (the Department) is releasing updated information about the assumptions underlying the care management component of capitation payments to NC Medicaid Managed Care Prepaid Health Plan (PHPs) Standard Plans. The PHP Standard Plan capitation rates developed by the Department reflect its belief that investment in robust community-based care management will drive improvements in care outcomes and achieve greater value from the state’s Medicaid dollar.
This bulletin replaces NC Medicaid Temporary Flexibilities Due to Hurricane Idalia published on Aug. 30, 2023, to correct the end date.