Medicaid Bulletin

Articles published prior to January 2018 are available in the Medicaid Bulletin Archive.

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Extension of Out-of-Network Provisions
The policy is extended through Nov. 30, 2021.
Expedited Hardship Advances for Managed Care Providers
May be available for those at risk of not meeting financial obligations
Collaborative Practice Agreements for Nurse Practitioners Supporting Members Diagnosed with Substance Use Disorders
Additional clarification about Nurse Practitioner credentialing requirements
Billing Guidance for Children’s Developmental Services Agency Providers
Claims may be submitted to NCTracks for all IFSP services for dates of service starting on July 1, 2021.
Procedures for Prior Authorization of Palivizumab (Synagis®) for Respiratory Syncytial Virus Season 2021-2022
Coverage season will begin Aug. 15, 2021
Prior Authorization for Physician Administered Drug Program
Not required for medications administered at the provider’s office or outpatient hospital clinic settings and billed as part of the professional claim (Physician Administered Drug Program).
New 2023 Deadline for Connecting to HIE Network Absolves Need for Hardship Extensions
The extension granted through the hardship process is now matched by the extension granted through new legislation.
Tailored Care Management Update: AMH+/CMA Certification Round One Desk Reviews Completed
NC Medicaid advanced 54 providers to the site review stage.
Potential Clinically Integrated Networks or Other Partners Statement of Interest
All responses have been received and are available.
Confirming Medicaid Coverage for Beneficiaries
Providers and pharmacies should always use NCTracks to confirm eligibility.