The Contract for Prepaid Health Plan Services (the State Contract) between the Department of Health and Human Services (the Department) and the selected Medicaid Managed Care plans (i.e., Prepaid Health Plans or PHPs) indicates that contracts between PHPs and providers shall comply with the terms of the State Contract and must be approved by the Department.

Effective with date of service March 12, 2019, the North Carolina Medicaid and NC Health Choice programs cover gemcitabine in sodium chloride injection, for intravenous use (Infugem) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - not otherwise classified, antineoplastic drugs.

One of the goals of a transformed health care system is for near real-time clinical and demographic data to be made available to all health care providers involved in a patient’s care so that they can securely share health information concerning that patient with each other.

North Carolina’s state-designated health information exchange, NC HealthConnex, was created in 2015 by the North Carolina General Assembly to help bridge the gap between disparate systems and health care networks to support whole patient care.

NC Medicaid has received calls concerning the ICD 10 diagnoses codes for acute appendicitis.

NC Medicaid has provided instructions to NCTracks on updating the diagnoses code list for acute appendicitis.