Local Health Departments will continue to offer Care Management for At Risk Children and Care Management for High-Risk Pregnancy services to Medicaid beneficiaries, with Per Member Per Month payments remaining in effect, both through Dec. 31, 2026.
Topics Related to Hospital Providers
Effective Jan. 1, 2026, The Acute Inpatient Hospital Services policy has been revised.
Recent court rulings now require the North Carolina Department of Health and Human Services to reverse provider rate reductions and restore rates to their Sept. 30, 2025, levels.
Providers should review Clinical Coverage Policy 2A-1 for information on Hospital Observation
Billing Requirements for Medicaid Direct Providers
Coverage Effective Nov. 1, 2023.
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.
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.
In compliance with federal requirements, beneficiary consent is required for all voluntary sterilizations.
Flexibilities ending at or after the end of the Federal Public Health Emergency
This bulletin provides guidance to assist hospital providers’ compliance with federal requirements.