Blog Entry List

This error occurred when the LARC was filled by a point-of-sale pharmacy and inserted by the provider in the clinic.
Certain vaccinations must be offered to Medicaid-eligible beneficiaries without a co-pay charge.
Ventolin® HFA will shift from Non-Preferred to Preferred on the Preferred Drug List (PDL), effective Sept. 23, 2022.
The PDAP Medicaid fee schedule requires multiple rate updates
Pharmacy Point of Sale claims for members enrolled Tailored Plans will be managed by NCTracks when Tailored Plans launch through March 31, 2023.
Edits are scheduled to resume on July 1, 2022
Effective May 1, 2022, claims with Rev Code 025x and 063x will deny without appropriate documentation of NDC and HCPCS codes.
Approved for treatment of mild to moderate COVID-19
Effective Feb. 1, 2022, Clinical Pharmacist Practitioner taxonomy code 1835P0018X will be allowed to bill and be reimbursed.
Revisions to previous scope of authorization
Certain immunocompromised children will qualify for third dose of Pfizer-BioN Tech Vaccine
Oral tablets covered for those in a home setting
FDA has expanded the use of single booster dose to include ages 12-15.
Effective with date of service Jan. 1, 2022 (updated from Sept. 29, 2021), the Medicaid and NC Health Choice programs cover Pfizer-BioNTech COVID-19 Vaccine (12 years of age and older).
Update on COVID-19 booster shot recommendations for Pfizer, Moderna and Janssen