Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Changes to the 1E-7 Family Planning Services Policy
The applicable ICD-10-Codes will be retroactive back to Jan. 1, 2023.
Pharmacy Coverage Reminders
Includes Pharmacy Point of Sale, Physician Administered Drug Program and Outpatient Hospital Pharmacy
Managed Care Billing Guidance for Health Plans Posted
This billing guidance supplements clinical policies and Medicaid bulletins.
NC Medicaid Electronic Visit Verification Revised Implementation Dates to Align with Transition of 1915(b) benefits to 1915(i) Authority
Revised EVV for Home Health Services implementation dates for NC Medicaid Direct, Standard Plans and Tailored Plans.
Lantus/Insulin Glargine Change on NC Medicaid Preferred Drug List
The insulin glargine vial and insulin glargine Solostar® will be added as Preferred on the NC Medicaid Preferred Drug List, effective Jan. 27, 2023.
Community Alternatives Program for Children Waiver Renewal
Proposed CAP/C Waiver renewal application submitted to CMS for review and approval
Payment Detail: Enhanced Medical Home Payments for Advanced Medical Homes Serving Members Eligible for Tailored Care Management
This bulletin replaces the Nov. 16, 2022, bulletin.
Healthy Opportunities Update - January 2023
The latest updates on enrollees and services delivered, success stories and how Providers can refer Medicaid Members.
Voluntary Reverification Coming Soon for Some Providers
Open to providers who were due for reverification during the Public Health Emergency. Ends March 31.
Pfizer-BioNTech COVID-19 Vaccine, Bivalent 6 Months through 4 Years HCPCS Code 91317: Billing Guidelines
Effective Dec. 8, 2022