New Medicaid Bulletin Articles Available as of Aug. 12

The NC Division of Health Benefits (DHB) has recently published new Medicaid Bulletin articles:

• Provider Categorical Risk Level Adjustment- Categorical Risk Level Subject to Bump-Up for Certain Providers.
• Utilization Management by NC Medicaid Managed Care Health Plans - August 2026- This bulletin replaces in full the December 2025 Utilization Management by Managed Care Plans Aligned with Food and Drug Administration Labeling bulletin.
• Updated 1915(i) Assessment and Companion Guide Now Available- The revised NC Medicaid 1915(i) assessment must be used starting Oct. 1, 2026, and includes a new companion guide.
• NC Medicaid Off-Cycle Change to the Preferred Drug List Due to Lantus SoloStar Pen Shortage- Effective July 24, 2026, Basaglar U-100 KwikPen moved to Preferred status due to reported shortage of Lantus SoloStar pen.
• Claim Submission Process When Eligibility is Retroactively Updated- Reminders for NC Medicaid Managed Care, NC Medicaid Direct and Medicare.
• Updated Reminder: Requirements for Research-Based Behavioral Health Treatment Service Delivery - Aug. 5, 2026- This bulletin reflects revised effective dates and applies to all research-based behavioral health treatment providers in NC Medicaid Managed Care and NC Medicaid Direct.
• Updates to Rate Increase for Personal Care Services and the Community Alternatives Program- This Medicaid bulletin replaces in full the July 31, 2026, Rate Increase for Personal Care Services and the Community Alternatives Program bulletin.

Providers are encouraged to review this information. All bulletin articles are available on DHB's Medicaid Bulletin webpage.