Medicaid Bulletin

Hospital at Home Program Re-Launch: NC Medicaid will cover the Acute Hospital at Home Program starting Nov. 1, 2023. NOTE: This Bulletin was revised on April 2, 2024 to correct an error. In the original version, published Sept. 27, 2023, it was stated that the Hospital at Home Program had a previous end date of March 31, 2021. Prior to relaunch, the previous end date was March 31, 2022, as corrected and explained below.

Effective with date of service May 26, 2023, NC Medicaid covers risperidone extended-release injectable suspension, for subcutaneous use (Uzedy)

Clinical Coverage Policy 8A, Enhanced Mental Health and Substance Abuse Services and 8C, Outpatient Behavioral Health Services

Additional clarification on implementation

Effective with date of service June 2, 2023, NC Medicaid covers epcoritamab-bysp injection, for subcutaneous use (Epkinly)

Mitigation process for any adverse impact for nursing facilities if a PASRR authorization is delayed.

Near Relatives and Legally Responsible Persons May Deliver Skilled Nursing Service to a PDN-eligible Beneficiary.

More than 600,000 people will gain access to quality care.

NC Medicaid Direct programs will transition to NCLIFTSS by Oct. 6, 2023

Claims without the required EVV data will be denied.