Medicaid has been informed that Wellcare and Carolina Complete have experienced an issue with their new PBM (Express Scripts), being set up to pay at 30 days instead of 14 days, resulting in pharmacies not being paid timely.
Payments for the first week in January are going out in the coming week. Payments for the second and third weeks will be on a 30-day cycle and will come out in mid-February, payments for the fourth week in January will also come out by mid-February. Pharmacies should be “caught up” in mid-February.
Penalties and interest will be paid in accordance with Section V. H.1.d of the NC PHP Contract. For more information, please see the Medicaid bulletin Prepaid Health Plan Interest and Penalties for Provider Claims.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.