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Get the free North Carolina Medicaid Pharmacy Newsletter - ncdhhs

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This newsletter provides updates and information relevant to Medicaid pharmacy claims, including new policies, drug coverage changes, claims processing updates, and mailing address changes for the
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How to fill out North Carolina Medicaid Pharmacy Newsletter

01
Access the North Carolina Medicaid Pharmacy Newsletter from the official website.
02
Review the latest updates and guidelines provided in the newsletter.
03
Identify the specific information or forms needed for your pharmacy practice.
04
Fill out any required forms or sections as directed in the newsletter.
05
Ensure all necessary contact information and pharmacy details are accurately provided.
06
Submit the completed newsletter form to the appropriate Medicaid representative.

Who needs North Carolina Medicaid Pharmacy Newsletter?

01
Pharmacy providers participating in the North Carolina Medicaid program.
02
Healthcare professionals who prescribe medications covered by Medicaid.
03
Medicaid beneficiaries who want to stay informed about pharmacy services.
04
Administrative staff working in pharmacies that serve Medicaid clients.
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Medicaid patients are increasingly facing procedural prescription denials, meaning their health plans refuse to cover medications for administrative reasons like early refills, plan limits on pill amounts or prior authorization rules.
The North Carolina Medicaid Pharmacy Program offers a comprehensive prescription drug benefit, ensuring low-income North Carolinians have access to the medicine they need.
The Beneficiary Management Lock-in Program restricts beneficiaries to a single prescriber and pharmacy for controlled substances categorized as opiates or benzodiazepines when one or more of the following criteria are met: a. Benzodiazepines: 10 or more claims in two consecutive months when not medically necessary.
Although pharmacy coverage is an optional benefit under federal Medicaid law, all states currently provide coverage for outpatient prescription drugs to all categorically eligible individuals and most other enrollees within their state Medicaid programs.
The North Carolina Medicaid Pharmacy Program offers a comprehensive prescription drug benefit, ensuring low-income North Carolinians have access to the medicine they need.
NC Medicaid Direct provides coverage to beneficiaries who cannot enroll in a health plan through NC Medicaid Managed Care.

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The North Carolina Medicaid Pharmacy Newsletter is a publication that provides updates and information related to Medicaid pharmacy services, including policy changes, clinical guidelines, and other pertinent information for providers.
Pharmacists and pharmacies that participate in the North Carolina Medicaid program are required to stay informed and may need to file relevant reports as directed in the newsletter.
Filling out the North Carolina Medicaid Pharmacy Newsletter typically involves following specific guidelines provided within the publication, detailing necessary updates and adhering to reporting requirements set by the North Carolina Medicaid program.
The purpose of the North Carolina Medicaid Pharmacy Newsletter is to communicate important updates, share educational resources, and ensure compliance with evolving Medicaid policies and procedures among pharmacy providers.
Reported information typically includes medication updates, policy changes, billing guidelines, clinical recommendations, and any other relevant operational details that affect pharmacy services under Medicaid.
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