Starting in November 2023, Standard Plans and Medicaid Direct will reprocess claims without appropriate documentation of required codes.
NC Medicaid is implementing changes due to Session Law 2023-14 and to implement additional clinical best practices for maternity care.
Instructions for providers requesting removal of NC Medicaid Direct members from their patient panel
Providers should submit claims for dates of service that now fall in NC Medicaid Direct.
Effective Nov. 1, 2023, NC Medicaid will remove all copay requirements for antiretroviral medications which decrease viral load in patients with HIV.
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.
Claims without the required EVV data will be denied.
This bulletin replaces NC Medicaid Temporary Flexibilities Due to Hurricane Idalia published on Aug. 30, 2023, to correct the end date.
Provider guidance for reimbursement, enrollment and providing care for Medicaid beneficiaries
This bulletin provides information about referrals for specialty care for NC Medicaid beneficiaries.
Includes flexibilities related to Tailored Plans and Healthy Opportunities Pilots
With state budget negotiations ongoing, NCDHHS has worked with CMS to negotiate a compromise to begin submitting documents needed for federal approval to launch Medicaid expansion on October 1, 2023.
All Home Health Care providers are expected to be fully compliant with requirements on Oct. 1, 2023.
This bulletin provides details on coverage for COVID-19 Vaccines and COVID-19 Counseling after the ending of the Federal Public Health Emergency.
New Temporary/Interim Estimated Budget Increases Added July 1, 2023.