Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

NC Medicaid Guidance on Sunsetting of Innovations Waiver Appendix K Flexibilities
Temporary flexibilities to the Innovations Waiver after Hurricane Helene are ending July 1, 2025.
NC Innovations Waiver: Supports Intensity Scale-Adult Version® 2nd Edition
The Centers for Medicare & Medicaid Services (CMS) requires individuals in the NC Medicaid Innovations waiver program to have a valid and comprehensive assessment.
Managed Care Electronic Visit Verification Home Health Implementation Hard Launch Effective Oct. 1, 2025
NC Medicaid’s Electronic Visit Verification (EVV) system for Home Health ensures compliance with federal requirements.
Healthy Opportunities Pilots Update
Budget proposals from the North Carolina General Assembly do not include funding for Healthy Opportunities Pilots services beyond June 30, 2025
Tobacco-Related Policy Requirements Delayed until Jan. 1, 2027
Tobacco-related policy requirements will be effective starting on Jan. 1, 2027.
Important Updates for Opticians
For more information, join the Virtual Office Hours webinar Thursday, June 5, 2025, at noon.
NC Managed Care Capitation Rates – Updated Care Management Assumptions for SFY 2026
Care Management rate considerations effective July 1, 2025.
Specialty Care Referrals in NC Medicaid – 2025 Update
Reminder: NC Medicaid does not require Carolina Access/Advanced Medical Home referrals for specialty care.
CSR 2814-Updates to Provider Suspension Process for Division of Mental Health, Developmental Disabilities and Substance Use Services (DMH/DD/SUS) Health Plans Effective June 1, 2025
NCTracks will align the suspension of DMH/DD/SUS health plans during the reverification process.
Carolina ACCESS Enrollment Refresher
Individual provider enrollment and Additional Managed Care Options