New Medicaid Bulletin Articles Available as of July 22nd

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

• Some Qualified Medicare Beneficiaries Now Have Coverage for Family Planning Services- For eligible individuals, NC Medicaid will now pay for Family Planning services in addition to Medicare premiums and cost sharing.
• Reminder: Requirements for Research-Based Behavioral Health Treatment Service Delivery- This bulletin applies to all research-based behavioral health treatment providers in NC Medicaid Managed Care and NC Medicaid Direct.
• Clinical Coverage Policy Update 1A-20 Sleep Studies and Polysomnography Services- Amendments to Clinical Coverage Policy 1A-20, expanding medical necessity criteria and updating coverage for sleep studies and polysomnography services are effective July 1, 2026.
• NC Medicaid Managed Care Capitation Rates – Updated Care Management Assumptions for SFY 2027- Care Management rate considerations effective July 1, 2026.
• Off-cycle Provider Reverification Taking Place This Fall for Certain Providers- Impacted NC Medicaid providers will be included in the Active Provider Reverification Report, and notifications with specific deadlines are expected by the end of September 2026.

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