Updates on NC Medicaid programs that received legislative increases to service rates in the Current Operations Appropriations Act of 2023
Topics Related to Medicaid Direct
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