Medicaid Bulletin

Effective with date of service Sept. 1, 2023, NC Medicaid covers talquetamab-tgvs injection, for subcutaneous use (Talvey).

Effective with date of service Aug. 15, 2023, the NC Medicaid programs cover elranatamab-bcmm injection, for subcutaneous use (Elrexfio).

Effective with date of service Aug. 19, 2023, NC Medicaid covers pozelimab-bbfg injection, for intravenous or subcutaneous use (Veopoz).

Effective with date of service Sept. 1, 2023, NC Medicaid Direct and NC Medicaid Managed Care cover cantharidin topical solution (Ycanth).

Effective with date of service Sept. 6, 2023, NC Medicaid Direct and NC Medicaid Managed Care cover avacincaptad pegol intravitreal solution (Izervay)

Effective with date of service Aug. 21, 2023, Medicaid covers aflibercept injection, for intravitreal use (Eylea HD)

The updated policy aims to minimize the impact of health plan accreditation on delegated care management entities

Flexibilities in the approved amendment will be effective March 1, 2024, and considered ongoing

North Carolina Medicaid will reimburse pharmacies for utilizing the statewide Self-Administered Hormonal Contraceptive Protocol for pharmacists.

NC Medicaid and the Division of Public Health (DPH) are alerting providers to the increased prevalence of syphilis in women of reproductive age; existing standards of care include testing all pregnant women at first prenatal visit, between 28-32 weeks and at delivery; and NC state law on sexually transmitted diseases.