Medicaid Bulletin

NC Medicaid Managed Care launched on July 1, 2021. Within the first 90 days of launch, beneficiaries can change their prepaid health plan (PHP) for any reason. The 90-day choice period ends on Sept. 30, 2021 for beneficiaries that moved to Managed Care on July 1, 2021.

Prepaid health plans are required to pay interest and penalties to providers if they fail to accurately pay or inappropriately deny a claim.

Topics include key dates, playbook updates, prior authorization, FAQs, contracting, ombudsman, webinars and more.

Oct 1, 2021 Update: The policy is amended with the effective date of Sept. 1, 2021.

Effective Oct. 15, 2021, CDSAs and independent practitioners providing individualized family service plan services must resume submitting PA requests.

The 2022 ICD-10 update is effective Oct. 1, 2021

Effective Aug. 18, 2021, the Medicaid and NC Health Choice programs cover anifrolumab-fnia injection

Tobacco-related policy requirements go into effect on July 1, 2022.

Two Months Left to Submit Program Year 2021 Attestations; Security Risk Analysis

Providers are encouraged to confirm which PA types are included in this long-term design.