Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Effective with date of service Nov 1, 2021, Medicaid and NC Health Choice programs cover pneumococcal 15-valent conjugate vaccine suspension for intramuscular injection (Vaxneuvance™).

Key dates, Playbook updates, Medicaid Direct, fabrication of eyeglasses, managed care eligibility for newborns, prior authorization, FAQs, Provider Ombudsman, Provider directory, PHP quick reference guides and help center.

Effective with date of service Oct. 22, 2021, Medicaid and NC Health Choice programs cover afamelanotide implant, for subcutaneous use (Scenesse®).

Summary network adequacy results for Standard Plans are available.

This group includes MAFDN Family Planning Medicaid and uninsured MCV beneficiaries.

Brief survey regarding electronic visit verification use in North Carolina

AMH Provider Manual 2.2 reflects North Carolina’s Integrated Care for Kids (InCK) pilot program expectations and changes that impact Advanced Medical Home Tier 3 contracts with Standard Plans.

Beginning Dec. 9, 2021, Medicaid and NC Health Choice will cover the Pfizer-BioNTech COVID-19 vaccine booster dose for administration to individuals age 16 and older.

COVID-19 vaccination has been approved for all pediatric patients who meet specific criteria regarding COVID-19.

Effective Dec. 31, 2021, NC Medicaid will end several of the temporary COVID-19 rate increases. Some of the rate increases in effect in December 2021 will be extended – at either current or revised levels - through Jan. 31, 2022.