The Board of Pharmacy commenced administrative rulemaking in three subject areas – Transfer of Prescriptions, Alternate Delivery Sites and Standardized Orders in Health Care Facilities. The Board will hold a public hearing on May 19 at 9:00 am at the North Carolina Board of Pharmacy, 6015 Farrington Road, Suite 201, Chapel Hill, NC 27517. Public comments are due on June 15.

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

Medicaid announced the NC Medicaid Pharmacy Benefits Administrator (PBA) system has successfully gone live. As you begin submitting POS claims, please note that the new PBA system strictly adheres to NCPDP requirements. Pharmacies are strongly encouraged to refer to the Payer Specification when submitting POS claims to ensure claims are billed correctly in alignment with NCPDP standards. If you have questions or need assistance, please contact the Prime Pharmacy Call Center at 844‑620‑6116.

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

The 2026 Short Legislative Session officially began on April 21. Lawmakers started introducing bills that comply with short-session rules, including measures with budget impacts, local legislation and proposals based on recommendations from interim study committees. 

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

All Medicaid providers are invited to participate in the 2026 Annual NCTracks Survey. This survey focuses on the aspects of NCTracks that involve direct customer interaction, such as the call center, provider relations, training and communications, as well as functional areas such as claims, prior approval and provider enrollment. Please note that this survey is regarding NC Medicaid Direct via NCTracks only (not related to Managed Care/health plans); please only answer questions in relation to NCTracks. Unless otherwise noted, the time period for which this survey applies is from July 1, 2025, to the present. The survey is anonymous unless you choose to identify yourself. 

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

The Board of Pharmacy has published proposed administrative rules (Page 1351) in the North Carolina Register concerning Test and Treat of Influenza. A public hearing will be held on March 17 at 9:00 am at the Board of Pharmacy, 6015 Farrington Road, Suite 201, Chapel Hill, NC 27517.  

Any person may object to the proposed rule changes by attending the public hearing on March 17 and/or by submitting a written objection by May 1 to Jay Campbell, Executive Director, North Carolina Board of Pharmacy, 6015 Farrington Road, Suite 201, Chapel Hill, NC 27517, fax (919) 246-1056 or e-mail ncboprulemaking@ncbop.org.  

For reference, here is information concerning the agreed upon protocols (found here) and (here), that the Board of Pharmacy and Medical Board have agreed upon and which was used to implement Test and Treat of Influenza under a statewide standing order issued by the State Health Director on September 30, 2025. 

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

Jay Ludlam is leaving his role as Deputy Secretary of Medicaid to move into a new role as Plan President with Molina Healthcare. Melanie Bush will serve as Interim Deputy Secretary, providing continuity and experienced leadership during the transition. Bush currently serves as the Assistant Secretary of Medicaid. 

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

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.

The latest Medicaid Pharmacy Newsletter, dated January 2026, is now available on the Medicaid website. In addition to the February 2026 check write schedule, this edition of the newsletter includes the articles: 

• Reminder: Immunizing Pharmacist Enrollment in NC Medicaid Contraceptives and NRT Protocol Reimbursement to Pharmacies 

• NC Medicaid's Participation in Centers for Medicare & Medicaid Services Cell and Gene Therapy Access Model for Sickle Cell Disease 

• North Carolina to Launch First-of-its-Kind NC Medicaid Managed Care Plan for Children and Families on Dec. 1, 2025 

• Billing Reminder of a Third-Party Prescription to Medicaid  

• NC Medicaid Reinstitutes Coverage for GLP-1s in Weight Management 

• Coming in May: New Pharmacy Benefits Administrator for NC Medicaid Direct  

 Providers are encouraged to review this important information. The 2026 Medicaid Pharmacy Newsletters can be viewed here.  

Also in North Carolina, the Sales and Use Tax Division of the Department of Revenue (NCDOR)  issued the following guidance on the application and remittance of sales tax as it relates to rounding due to the elimination of the penny. As noted in the guidance, any rounding due to the elimination of the penny should be conducted after the application of sales and use tax and all applicable sales and use tax must be remitted by the retailer to the NCDOR regardless of whether the retailer rounded up or down. 

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

The latest Medicaid Pharmacy Newsletter, dated December 2025, is now available on the Medicaid website. In addition to the January 2026 checkwrite schedule, this edition of the newsletter includes the following articles:

• Reminder: Immunizing Pharmacist Enrollment in NC Medicaid Contraceptives and NRT Protocol Reimbursement to Pharmacies
• NC Medicaid’s Participation in Centers for Medicare & Medicaid Services Cell and Gene Therapy Access Model for Sickle Cell Disease
• Discontinuation of Coverage: Xifaxan (Rifaximin)
• North Carolina to Launch First-of-its-Kind NC Medicaid Managed Care Plan for Children and Families on Dec. 1, 2025
• Billing Reminder of a Third-Party Prescription to Medicaid
• NC Medicaid Reinstitutes Coverage for GLP-1s in Weight Management

Also in North Carolina, following the recent announcement of the Rural Health Transformation Program (RHTP) award by CMS, the state reaffirmed its commitment to continue collaboration with a broad coalition of state agencies, rural providers, community partners, academic institutions and the private sector. To advance this collaboration, the Department of Health and Human Services will host a virtual town hall on January 16 to outline program goals, discuss next steps and highlight the anticipated statewide impact. Additional details and registration information will be shared soon. For updates and more information, visit the NC Rural Health Transformation Program webpage.

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