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

Permanent flexibilities approved in the Innovations Waiver amendment effective March 1, 2024.

NC Managed Care Capitation Rates – Updated Care Management Assumptions for Expansion Population

Includes rate considerations for Medicaid Expansion members effective Dec. 1, 2023.

Over-the-Counter COVID-19 Test for Home Use Pharmacy POS Coverage

CorDx, GoToKnow, FaStep COVID-19 AG Home Tests added to coverage.

Electronic Visit Verification for NC Medicaid-Funded Personal Care Services and Home Health Services

Manual entries and Sandata Mobile Connect 2.0.

Quality of Care Fact Sheets Available

Fact sheets provide key findings, trends, improvements and new programs

Reminder for Home Health Providers: Associations in the Sandata System

How to create an association in Sandata allowing providers to work with their clients

New Exclusion Sanction Questions to be added to Applications for Provider Enrollment

Beginning Jan. 28, 2024, five new additional exclusion sanction questions will be added.

NC Medicaid to Revise the Physician Administered Drug Program (PADP) Fee Schedule

NC Medicaid will update the PADP fee schedule effective Feb. 1, 2024.

Guidance for Private Duty Nursing Providers

How to best serve beneficiaries who have not received nursing services for 30 consecutive days.

Additional NC Medicaid Respiratory Syncytial Virus (RSV) Guidelines for 2023-2024

This bulletin replaces the NC Medicaid Respiratory Syncytial Virus (RSV) Guidelines for 2023-2024 - Revised published Nov. 3, 2023.