The North Carolina COVID-19 state of emergency sunsets on August 15, 2022. For more information on how it affects pharmacy practice please click here.
Also in North Carolina, pharmacy claims processing under Behavioral Health and Intellectual/Developmental Disabilities (I/DDs) Tailored Plans. Pharmacy Point of Sale (POS) claims for members enrolled in Tailored Plans will be temporarily managed by NCTracks when the plans launch on Dec. 1, 2022, through March 31, 2023. Beginning on April 1, 2023, these claims will be managed by the Tailored Plans. This change was made due to a key Pharmacy Benefit Manager (PBM) unexpectedly leaving the NC Medicaid market in late 2021, which required some Tailored Plans to procure another PBM.
There will be no impact to members’ pharmacy benefits during this transition period. From Dec. 1, 2022, through March 31, 2023, member ID cards will not include pharmacy information. A new card will be issued for April 1, 2023, indicating the new RxBin and PCN numbers for the Tailored Plans.
NC Medicaid will reach out to members, pharmacists, and providers in the coming months with additional information about this transition. For more information, please see the Medicaid bulletin Pharmacy Point of Sale Process at Tailored Plan Launch.
Finally, please see August 2022 NC Medicaid Pharmacy Newsletter which contains information on the below.
- NC Medicaid Pharmacy Point-of-Sale Billing for Pharmacist-Prescribed Paxlovid
- October 2022 Drug Use Review (DUR) Board Meeting
- Reminder Regarding the Naloxone Standing Order
- Pharmacy Point of Sale Process at Tailored Plan Launch
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.