Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

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The North Carolina Department of Health and Human Services (NCDHHS) reminds pharmacy providers that Prime Therapeutics State Government Solutions LLC (Prime Therapeutics) will serve as the Pharmacy Benefits Administrator (PBA) for NC Medicaid Direct point-of-sale (POS) pharmacy benefits beginning May 2, 2026.
The Department is no longer requiring compliance with Tobacco-free Campus Policy Requirements by Jan. 1, 2027.
Applications must be submitted no later than March 22, 2026, at 11:59 p.m.
An out-of-date NCTracks provider record jeopardizes continued NCDHHS program participation.
For NC Medicaid and Division of Mental Health, Developmental Disabilities, and Substance Use Services (DMHDDSUS) State Funded Behavioral Health Providers.

NOTE: This change applies only to NC Medicaid Direct beneficiaries. There is no impact to beneficiaries enrolled in NC Medicaid Managed Care.

Flexibilities extended through Feb. 6, 2026, for NC Medicaid beneficiaries due to additional Winter Storm weather.
Information on Required Provider Disclosures, Children and Families Specialty Plan Flexibilities, Case Manager/Care Coordinators Updates and more.
Flexibility extended to Jan. 30, 2026, for NC Medicaid beneficiaries due to Winter Storm.
Assessment rates were affected by the implementation and subsequent reversal of the Oct. 1, 2025, per diem rate reductions.