A Message from NCTracks on Behalf of NC Medicaid Updates to NC Medicaid Payments to Prohibited Entities

H.R.1 (Pub. L. No. 119-21) was signed into law on July 4, 2025, by President Trump. H.R.1 prohibits Medicaid payments to certain prohibited entities for one year, effective July 4, 2025. This provision was temporarily blocked from implementation by a Federal District Court Judge, who issued a temporary restraining order (TRO) effective through July 21, 2025. This TRO only applied to Planned Parenthood.   

The most recent court order issued on July 21, 2025, does not apply to NC Planned Parenthood entities (Planned Parenthood South Atlantic) based on claims payments made in 2023. 

At this time, NC Medicaid-enrolled organizations with the legal name “Planned Parenthood South Atlantic” are impacted by this provision.

• These providers may continue to receive payment from NC Medicaid for services rendered with Dates of Service (DOS) through July 21, 2025.  
• NC Medicaid payments will cease for identified prohibited entities.   
• NC Medicaid will automatically reprocess and recoup any paid claims for DOS on or after July 22, 2025, that are not in compliance with this provision. 

Impacted providers should work with their NC Medicaid members to support transition to other providers for care. Providers and beneficiaries may use the NC Medicaid Provider and Health Plan Lookup Tool to explore options in their area.    

For additional information, please see Medicaid provider bulletin Updates to NC Medicaid Payments to Prohibited Entities posted on July 25, 2025.