This is an update to the September 2016 Medicaid Ordering, Prescribing or Referring Special Bulletin.
Topics Related to Medicaid Managed Care
This bulletin has updated end dates & additional flexibilities for Behavioral Health, Care Management, Innovations, and Long-Term Services & Supports.
This bulletin applies to NC Medicaid Direct and NC Medicaid Managed Care. NC Medicaid is committed to ensuring continued access to care for NC Medicaid beneficiaries. As a service to both NC Medicaid beneficiaries and providers, NCTracks has created a webpage listing of all enrolled out-of-state (OOS) pharmacies, categorized by state.
NC Medicaid will continue the current Tailored Care Management temporary payment rate of $343.97 statewide through June 30, 2025.
Includes information on Change of Ownership Requirement, Upcoming Webinars, and more.
Effective Jan. 1, 2025, the unit of reimbursement will change from a 15-minute increment to a daily per diem.
Includes information on vaccine reimbursement, billing, counseling coverage and Immunization Program/Vaccines for Children
Health plans are required to pay interest to providers if they fail to accurately pay or inappropriately deny a claim.
For providers unable to provide services under an active, approved service plan due to the impacts of Hurricane Helene.