NC Medicaid is providing updated information to providers about the federal prohibitions on certain providers.
Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
NC Medicaid has revised or removed several Tailored Care Management trainings, and identified a refresher and elective curriculum.
Request to Move forms for members in the Children and Families Specialty Plan to move to a Behavioral Health I/DD Tailored Plan do not need to complete a Service-associated Request.
Providers should continue to follow the certification and waiver requirements described below.
This guidance is based on products approved by the FDA and recommended by the CDC Advisory Committee on Immunization Practices.
This guidance is based on the NC Immunization Program/Vaccines for Children guidelines.
Wegovy and Zepbound for indications other than weight loss to be covered based on the indications and usage criteria published in the FDA label, pending updated clinical criteria.
Exclusion Sanction questions must be accurately answered on applications and new adverse actions must be reported to the Department.
A psychiatric diagnostic interview (Current Procedural Terminology 90792) may qualify as a Comprehensive Clinical Assessment if it meets all requirements.
This bulletin replaces in full NC Medicaid Rate Reductions – Effective Oct. 1, 2025, published Sept. 25, 2025.