Recent court rulings now require the North Carolina Department of Health and Human Services to reverse provider rate reductions and restore rates to their Sept. 30, 2025, levels.
NC Medicaid Managed Care plans may apply utilization edits and/or prior authorization criteria per the Food and Drug Administration label on drugs when the State has not established criteria and has not prohibited use of criteria.
Request to Move forms for members in the Children and Families Specialty Plan to move to a Behavioral Health I/DD Tailored Plan do not need to complete a Service-associated Request.