New Medicaid Bulletin Articles Available as of May 7

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

• Use of the Pharmacy National Provider Identifier for Point-of-Sale Protocol Claims Ending May 2026- Effective May 2, 2026, use of the pharmacy National Provider Identifier in the prescriber field on Point-of-Sale claims for all protocol drugs will no longer be allowed..
• NC Medicaid Update on the Care Management for At-Risk Children and Care Management for High-Risk Pregnancy Programs- Local Health Departments will continue to offer Care Management for At Risk Children and Care Management for High-Risk Pregnancy services to Medicaid beneficiaries, with Per Member Per Month payments remaining in effect, both through Dec. 31, 2026.
• Pharmacy Benefit Administrator: Now Live for NC Medicaid Direct- Prime Therapeutics is the New Pharmacy Benefit Administrator for NC Medicaid Direct Point of Sale Pharmacy, effective May 2, 2026.

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