NC Medicaid has contracted with Health Management Systems to conduct Overpayment Recovery Reviews for Medicaid beneficiaries.
Medicaid Bulletin
Articles published prior to January 2018 are available in the Medicaid Bulletin Archive.
Updating the date format requirement for Hospital UR Plan submission.
Important information for Behavioral Health organization providers, including those enrolled in taxonomy 251S00000X.
Providers selected for quarterly NC Medicaid Internal Audits will be notified only using the QiRePort Provider Interface.
Redistributing Previously Approved Shared Private Duty Nursing Hours Among Service Providers without a New CMS-485 or PDN Ordering Provider Order, Effective September 1, 2026
Beginning Nov. 1, 2026, Pharmacy Claims for controlled substances will be denied without an active certification on their NCTracks provider enrollment record.
This bulletin reflects revised effective dates and applies to all research‑based behavioral health treatment providers in NC Medicaid Managed Care and NC Medicaid Direct.
This fall, care managers, caregivers and providers supporting high‑risk Medicaid beneficiaries are invited to join a three‑part webinar series focused on preparing for, responding to and recovering from extreme weather events.
Recent updates have been made to the new NC Medicaid 1915(i) Assessment form.
Categorical Risk Level Subject to Bump-Up for Certain Providers.