Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

REMINDER: Healthy Opportunities Services Available
Providers can refer patients to Healthy Opportunities Pilot services
Co-Pays Cannot be Charged to Medicaid or NC Health Choice Beneficiaries for Vaccinations Administered at a Pharmacy
Certain vaccinations must be offered to Medicaid-eligible beneficiaries without a co-pay charge.
Application Period Open for Round 3 Tailored Care Management Certification
Join DHHS Sept. 29, 2022, at 3:30 p.m. for more information. Statement of intent due Nov. 10, 2022.
SPECIAL BULLETIN COVID-19 #264: Pfizer & Moderna Bivalent COVID-19 Booster Vaccines
Pfizer & Moderna Bivalent COVID-19 booster vaccine billing and claims information
ProAir Manufacturer Discontinuation
Ventolin® HFA will shift from Non-Preferred to Preferred on the Preferred Drug List (PDL), effective Sept. 23, 2022.
Ensure Your Information Displays Correctly in NC’s Provider Directory Tool – Provider & Health Plan Look-Up
Every page of the NCTracks provider record should be assessed for accuracy.
Procedures for Prior Authorization of Palivizumab (Synagis®) for Respiratory Syncytial Virus Season 2022/2023
Coverage season starts Oct. 1, 2022.
ICD-10 Annual Update Reminder
The 2023 ICD-10 update is effective Oct. 1, 2022, through Sept. 30, 2023, for provider use for dates of service within this period.
Provider Claims Payment Issues
Providers should contact the PHPs and Provider Ombudsman to resolve issues.
NC Medicaid Managed Care Provider Update – Sept. 16, 2022
Key milestones, playbook updates, verifying eligibility, provider reverification, provider records, behavioral health services transition and more