Medicaid Bulletin

NC Medicaid licensed pharmacists are authorized to order and administer REGEN-COV monoclonal antibodies and pharmacy technicians/interns may administer it, in accordance with the conditions of their licensure and/or scope of practice.

NC Medicaid is extending all current COVID-19 temporary provider rate increases through Nov. 30, 2021. While the rate increases for providers authorized under SL 2020-4 were set to expire on June 30, 2021, NC Medicaid has discretion to continue these and other temporary rate increases assuming budget availability.

NC Medicaid Managed Care launched on July 1, 2021. Within the first 90 days of launch, beneficiaries can change their prepaid health plan (PHP) for any reason. The 90-day choice period ends on Sept. 30, 2021 for beneficiaries that moved to Managed Care on July 1, 2021.

Prepaid health plans are required to pay interest and penalties to providers if they fail to accurately pay or inappropriately deny a claim.

Topics include key dates, playbook updates, prior authorization, FAQs, contracting, ombudsman, webinars and more.

Oct 1, 2021 Update: The policy is amended with the effective date of Sept. 1, 2021.

Effective Oct. 15, 2021, CDSAs and independent practitioners providing individualized family service plan services must resume submitting PA requests.

The 2022 ICD-10 update is effective Oct. 1, 2021

Effective Aug. 18, 2021, the Medicaid and NC Health Choice programs cover anifrolumab-fnia injection

Tobacco-related policy requirements go into effect on July 1, 2022.