This bulletin applies to NC Medicaid Managed Care and NC Medicaid Direct.
Per Centers for Medicare & Medicare Services (CMS) notification on April 23, 2026, NC Medicaid is requested to conduct off-cycle, expedited provider reverification with a focus on high-risk providers, including National Provider Identifier (NPI) and atypical providers. The list of impacted providers will be included on a tab called “CMS_HighRisk_Atypical” in the Active Provider Reverification Report, posted on the Provider Enrollment Recredentialing webpage.
The CMS High Risk Atypical tab includes providers identified as either NPI or atypical providers who are classified as high categorical risk level and meet one of the following:
- Have not been reverified in the last 12 months.
- Are due within the next 12 months.
The process to initiate this reverification is currently under development, and notifications with specific deadlines for application submission are expected in late September 2026. Impacted providers should monitor their NCTracks secure Provider Message Inbox and email for notifications.
Contact
- NCTracks Call Center: 800-688-6696
- Provider Ombudsman: 866-304-7062