Medicaid Bulletin

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.

Effective with date of service July 31, 2023, NC Medicaid covers rezafungin for injection, for intravenous use (Rezzayo)

Effective with date of service June 14, 2023, NC Medicaid covers pegunigalsidase alfa-iwxj injection, for intravenous use (Elfabrio).

Effective with date of service June 27, 2023, NC Medicaid covers glofitamab-gxbm injection, for intravenous use (Columvi)

Effective with date of service July 11, 2023, NC Medicaid covers efgartigimod alfa and hyaluronidase-qvfc injection

This bulletin replaces NC Medicaid COVID-19 Vaccine and Reimbursement Guidelines for 2023-2024

Effective July 15, 2023, NC Medicaid covers beremagene geperpavec-svdt biological suspension mixed with excipient gel for topical application