Medicaid Bulletin

An updated draft of NC Medicaid’s Managed Care Quality Strategy is posted for public comments until May 6, 2021. 

The NC Medicaid Annual Quality report and an updated NC Medicaid Managed Care Quality Measurement Technical Specifications Manual are available.

NCDHHS has implemented a PCP practice reassignment process to better match beneficiaries to the PCP with whom they already have an active relationship with to help ensure the best health plan is selected during auto-enrollment.

Upcoming stakeholder sessions are announced for the Community Alternatives Program for Children (CAP/C) waiver, which will expire on Feb. 28, 2022. By October 2021, NC Medicaid will submit a request to the Centers for Medicare and Medicaid Services (CMS) to renew the CAP/C waiver.  

Effective with date of service Jan. 28, 2021, the Medicaid and NC Health Choice programs cover remimazolam for injection, for intravenous use (Byfavo™).

An amended version of Clinical Coverage Policy 1E-7, Family Planning Services, with an effective date of May 1, 2021, will post to the NC Medicaid Clinical Coverage Policy webpage.

Clinical Coverage Policy 1A-41, Office-Based Opioid Treatment is being updated to add buprenorphine for the treatment of patients aged 16 years and older.

Effective with date of service Feb. 1, 2021, the Medicaid and NC Health Choice programs cover cabotegravir extended-release injectable suspension; rilpivirine extended-release injectable suspension, co-packaged for intramuscular use (Cabenuva™).

NC Medicaid will extend the pay and report period for providers subject to Electronic Visit Verification (EVV) past the original cutoff date of March 31, 2021. Medicaid will provide 30 days’ notice prior to the conclusion of pay and report.   

This Bulletin gives guidance on the use of EVV for the Community Alternatives Programs for Children and Disabled Adults (CAP/C and CAP/DA) to ensure compliance with Section 12006 of the 21st Century Cures Act.