Medicaid Bulletin

PHPs are required to provide drug coverage to Medicaid beneficiaries consistent with the drug coverage determined by NC Medicaid under fee for service.

To support providers during the recent COVID-19 surge, the policy for in-network provider provisions has been extended

Taxonomy codes must be included when submitting claims to prepaid health plans

Ensure compliance with the HCBS final rule and prepare Tailored Plans and Providers for the launch of Tailored Care Management.

Effective with date of service July 8, 2021, the Medicaid and NC Health Choice programs cover oritavancin for injection, for intravenous use.

Effective with date of service June 28, 2021, the Medicaid and NC Health Choice programs cover dasiglucagon injection, for subcutaneous use (Zegalogue®)

Effective with date of service July 1, 2021, the Medicaid and NC Health Choice cover bupivacaine and meloxicam extended-release solution.

Effective with date of service July 15, 2021, Medicaid and NC Health Choice cover asparaginase erwinia chrysanthemi (recombinant)­-rywn injection, for intramuscular use (Rylaze™)

To assist providers in navigating the managed care health plans' PCS referral and intake process, NC Medicaid has partnered with the health plans to implement a short-term solution for ACH providers who deliver PCS services.

The FDA has modified the Emergency Use Authorizations (EUAs) for Pfizer-BioNTech COVID-19 vaccine and Moderna COVID-19 vaccine to allow for administration of a third dose of an mRNA COVID-19 vaccine after an initial two-dose primary mRNA COVID-19 vaccine series for certain immunocompromised people.