Medicaid will be launching a new Pharmacy Benefit Administrator (PBA) on May 2. As part of this transition, the pharmacy component of NCTracks will be decommissioned and moved to the new PBA operated by Prime Therapeutics. Beginning May 2, the new PBA will process Point-of-Sale pharmacy claims for Medicaid Direct.

The Managed Care Plans will continue to operate as they do today. There is no change to their PBM or Point-of-Sale pharmacy processing. This transition only impacts beneficiaries utilizing Medicaid Direct.

To support a smooth transition, there will be a series of provider education webinars:

  1. Provider Webinar #1 (Hosted by Prime): Scheduled for March 20, this session will focus on high-level PBA transition information and include a live system demo from Prime Therapeutics.
  2. Provider Webinar #2: Tentatively planned for April 21, this session will provide a deeper dive into operational functions of the Prime PBA and address any hot topics identified during the first webinar.

For more information, visit the PBA website.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.