Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Vutrisiran Injection, for Subcutaneous Use (Amvuttra™) HCPCS Code J3490: Billing Guidelines
Effective June 21, 2022, Medicaid and NC Health Choice cover Vutrisiran injection, for subcutaneous use (Amvuttra).
Risankizumab Injection, for Intravenous Use (Skyrizi®) HCPCS Code J3590: Billing Guidelines
Effective June 22, 2022, Medicaid and NC Health Choice cover Risankizumab-rzaa Injection, for intravenous use (Skyrizi).
Physician Administered Drug Program Drug Update
The PDAP Medicaid fee schedule requires multiple rate updates
Consumer Assessment of Healthcare Providers and Systems Survey Results Released
CAHPS is a patient experience survey that serves as a national standard for measuring and reporting respondents’ experiences with their health care.
Baseline Medicaid Provider Experience Survey Report Released
Evaluates the impact of the North Carolina Medicaid Transformation on primary care and obstetrics/gynecology (Ob/Gyn) practices
Updates to Clinical Coverage Policy 5A-2, Respiratory Equipment and Supplies
An amended version is posted with an effective date of Aug. 1, 2022
2022 and 2023 Advanced Medical Home Measure Targets
Quality metrics that will assess health plans’ performance across their populations
Retroactive Disenrollment from NC Medicaid Managed Care
A delay in identifying individuals in NCTracks as dually eligible for Medicare and Medicaid has been discovered.
Influenza Vaccine and Reimbursement Guidelines for 2022-2023 for NC Medicaid and NC Health Choice
Updates for NC Immunization Program/Vaccines for Children and Medicaid Beneficiaries
Community Alternatives Program for Children Waiver Renewal
Proposed CAP/C Waiver renewal posted for public comment