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Committees and Work Groups

The Department of Health and Human Services and NC Medicaid are committed to working with beneficiaries, caregivers, providers, associations and other stakeholders to improve health care in North Carolina. Below is information for committees and work groups engaged in this collaborative process. Click on a group title for more information.

Dual Eligibles Advisory Committee

The Dual Eligibles Advisory Committee, established according to Session Law 2015-245, provides advice to the Department of Health and Human Services as it developes a long-term strategy to cover dual eligibles under Medicaid reform. 

HIV Case Management

HIV Case Management is a client-focused strategy that provides cost-effective, medically necessary services to enhance beneficiary health status and level of functioning. 

Medical Care Advisory Committee (MCAC)

Federal law requires that states have a Medical Care Advisory Committee (MCAC) to advise them about health and medical care services that may be covered by their local Medicaid programs. In North Carolina, MCAC advises the state about such issues as revisions to existing policies, policy development, and methods of assessing the quality of care, for both Medicaid and NC Health Choice.

Money Follows the Person (MFP)

Money Follows the Person (MFP) is a state project that heljps Medicaid-eligible North Carolinians who live in inpatient facilities moveinto their own homes and communities with support. If you are interested in receiving MFP updates and meeting notices, please email us at mfpinfo@dhhs.nc.gov

North Carolina Drug Utilization Review Board

The NC Medicaid Drug Utilization Review (DUR) program for outpatient drugs ensures Medicaid recipients receive appropriate, medically necessary prescriptions that are unlikely to result in adverse medical events. 

Personal Care Services (PCS) Stakeholder Group

The Personal Care Services (PCS) Stakeholder Group provides citizens interested in the development and implementation of Personal Care Services with the opportunity to collaborate and share recommendations. The N.C. Department of Health and Human Services meets bi-monthly with community stakeholders to share project status, gather input and identify next steps.

Preferred Drug List (PDL) Review Panel

The Medicaid and Health Choice Preferred Drug List (PDL) Review Panel was established by DHHS to conduct open meetings to discuss recommended policies and procedures related to the PDL and to address the public comments that were received during the PDL comment period. The administration and review of the North Carolina Medicaid and Health Choice PDL follows the Preferred Drug List Review Panel Guidelines and Procedures.

Private Duty Nursing (PDN) Stakeholders 

Private Duty Nursing (PDN) is substantial, complex, and continuous skilled nursing care provided in the home for medically fragile Medicaid beneficiaries. This service is considered supplemental to the care provided by a beneficiary’s family or designated caregivers, and allows the beneficiary to remain in their residence rather than an institution. Prior approval (PA) is required for PDN services, and is granted based on the beneficiary’s medical necessity and fragility.

Quarterly Stakeholder Engagement

As valued partners of NC Medicaid, we are requesting your participation in a winter stakeholder engagement session. The purpose of this session is to provide an update on Medicaid Managed Care and quality improvement initiatives, share proposed revisions to the Private Duty Nursing (PDN) policies, and receive feedback and suggestions about proposed policy changes. Please share this invitation with your beneficiaries and their caregivers. For more information and registration, click here

Date: Friday, Dec. 13, 2019
Time: 2:30 – 4:00 p.m. 

NC Drug Utilization Review Board

The NC Medicaid Drug Utilization Review (DUR) program for outpatient drugs ensures Medicaid recipients receive appropriate, medically necessary prescriptions that are unlikely to result in adverse medical events.

NC DUR Board meetings are held quarterly in the following location. They are open to the public.

NC Medicaid
Kirby Building, Room 297
1985 Umstead Drive
Raleigh, NC 27603

Meetings

2019

Thursday, January 31, 2019, 1-3 p.m. **Note change in date**

Agenda

Thursday, April 25, 2019, 1-3 p.m.
Thursday, July 25, 2019, 1-3 p.m.
Thursday, October 24, 2019, 1-3 p.m.

2018

Thursday, January 25, 1-3 p.m.

Agenda - Jan. 25

Thursday, April 26, 1-3 p.m.

Agenda - April 26


Thursday, July 26, 1-3 p.m.
Thursday, October 25, 1-3 p.m.

2017

Thursday, Jan. 26, 1-3 p.m. 

Minutes - Jan. 26

Thursday, April 27, 1-3 p.m. 
Thursday, July 27, 1-3 p.m. 
Thursday, Oct. 26, 1-3 p.m. 

Preferred Drug List Review Panel

    The Medicaid and Health Choice Preferred Drug List (PDL) Review Panel was established by DHHS to conduct open meetings to discuss recommended policies and procedures related to the PDL and to address the public comments that were received during the PDL comment period. The administration and review of the North Carolina Medicaid and Health Choice PDL follows the Preferred Drug List Review Panel Guidelines and Procedures.

    To sign up to speak at the PDL Review Panel Meeting, send an email to Medicaid.PDLReviewMeeting@lists.ncmail.net.  Please include the name of the speaker, the represented organization and the drug name.  You may attach any clinical information regarding the drug you wish the PDL Panel to review beforehand.  Presentations are allowed only in the drug classes with changes and should not exceed three minutes.

    Review Panel Meeting

    May 22, 2019

    Meeting Archives

    2010-2018

    Recommendations and Reports

    PDL Panel Members

    Aug. 1, 2018 – July 31, 2020
    Panel Member Position Organization
    John Stancil, Jr., BSPh Pharmacist Pharmacy Director, Division of Health Benefits
    Seung Kim, MD Physician Old North State Medical Society
    Ann McGee, PharmD Pharmacist Hospital-Based Pharmacy
    Janice Huff, MD, FAAFP PhysicianPhysician Community Care of North Carolina
    Casey Johnson, PharmD Pharmacist N.C. Association of Pharmacists
    Anna Miller-Fitzwater, MD Physician N.C. Pediatric Society
    Theodore Zarzar, MD Physician N.C. Psychiatric Association
    Duncan Vincent, MD, FACP Physician N.C. Chapter of the American College of Physicians
    Jessica Triche, MD Physician N.C. Academy of Family Physicians
    Tracy Furgiuele, BSPh Pharmacist Research-Based Pharmaceutical Company 
    Lawrence Greenblatt, MD Physician N.C. Physician Advisory Group Pharmacy and Therapeutics Committee

    Contact

    NC Medicaid Home Care Services
    Phone: 919-855-4360