Topics Related to Medicaid Direct

Process change for Providers identifying Other Found Insurance for NC Medicaid Managed Care Members

A new prior authorization is required for beneficiaries returning to NC Medicaid Direct

Behavioral health prior authorizations effective April 1, 2023

As of April 1, 2023, all NC Health Choice beneficiaries with active eligibility will be moved to Medicaid.

Home Health Care Services: Soft Launch April 1, 2023 through June 30, 2023; Provider Selection of Electronic Visit Verification Vendor

This report describes findings from the second assessment of provider experience and satisfaction with the NC Medicaid program.

Policy updates for NC Medicaid Direct beneficiaries in the Obstetrical Services and Pregnancy Management Program policies, retroactive to Jan. 1.

Note: This bulletin is replaced by NC Health Choice Move to Medicaid: Timeline for Claims Adjudication and Process for Prior Approvals.

NC Medicaid is implementing new Managed Care Nursing Facility rates to support nursing facility providers and NC Medicaid members.

Key milestones, playbook updates, verifying eligibility, provider reverification, provider records, behavioral health services transition and more