As measles cases continue to rise across North Carolina and the surrounding region, it’s important for practice staff and managers to be equipped with clear, up‑to‑date information. This guidance combines essential material from the Measles Patient FAQ (Jan. 15, 2026) and reporting from North Carolina Health News, tailored specifically for frontline teams and leaders working to maintain high‑quality, safe clinical environments.

We encourage all practices to review the details below and share them with their teams.

What Is Measles?

Measles is a highly contagious viral illness that spreads quickly in unvaccinated populations. Early symptoms include:

• High fever (often >104°F)
• Cough
• Runny nose
• Red or watery eyes
• A rash starting on the face, spreading downward
• Small white mouth spots (Koplik’s spots) [Debrief Re...Ethics_v2 | PowerPoint]

Measles can cause severe complications—especially among children, older adults, and immunocompromised patients—making early identification essential in clinical settings.

How It Spreads — and Why Practices Should Stay Alert

The measles virus can remain airborne for up to two hours after an infected person leaves the area. Approximately 90% of unvaccinated individuals exposed will become infected. [Debrief Re...Ethics_v2 | PowerPoint]

Given this high infectivity, even a brief clinic exposure may require rapid response and coordinated communication with public health partners.

Why North Carolina Is Seeing More Cases

Recent reporting from North Carolina Health News highlights a continued rise in statewide measles cases, many linked to the ongoing outbreak in Spartanburg County, SC. Key takeaways include:

• Cases in NC have increased since December, primarily among unvaccinated children.
• Early symptoms may not be recognized immediately, allowing unintentional spread.
• The two‑dose MMR vaccine remains the most reliable prevention tool. [northcarol...thnews.org]

For practice leaders, this underscores the importance of reinforcing vaccination outreach, screening protocols, and rapid response workflows.

MMR Vaccination Guidance for Patients

Vaccination remains the strongest protection.

Standard schedule

• First dose: 12–15 months
• Second dose: 4–6 years [Debrief Re...Ethics_v2 | PowerPoint]

Adult considerations

Most adults with two documented doses do not need a booster; those uncertain should speak with their provider. Immunity testing is not recommended for those with two recorded doses. [Debrief Re...Ethics_v2 | PowerPoint]

In outbreak areas

Providers may consider early second doses or early infant vaccination (6–12 months), depending on risk. [Measles Patient FAQ | PDF]

Exposure Guidance to Share with Patients

Your local health department determines what meets the criteria for exposure.

If vaccinated (2 doses) or born before 1957:

• No post‑exposure treatment
• No work restrictions
• Monitor for symptoms days 5–21
• Call the clinic or health department if symptoms appear [Debrief Re...Ethics_v2 | PowerPoint]

If unvaccinated, unsure, or immunocompromised:

• May require prophylaxis
• Stay home days 5–21 after exposure
• Contact healthcare provider promptly with any symptoms [Debrief Re...Ethics_v2 | PowerPoint]

Guidance for Managing Pediatric Populations

When coaching your teams, emphasize:

• Infants 0–6 months: Avoid exposure entirely
• Infants 6–12 months: Discuss early MMR dose when appropriate
• Children with one dose: Consider early second dose during outbreaks
• Unvaccinated children: Begin the MMR series immediately [Measles Patient FAQ | PDF]

If measles is suspected, have families call before arrival so your clinic can prepare isolation precautions. [Measles Patient FAQ | PDF]

Testing, Treatment & Clinical Considerations

There is no antiviral treatment for measles. Vitamin A may be used in treatment after infection but does not prevent illness. Only the MMR vaccine prevents disease. [wunc.org]

Practices should reinforce workflows for:

• Prompt masking and isolation
• Airborne precautions where possible
• Immediate notification of Infection Prevention or public health partners
• Reviewing room‑closure procedures for airborne pathogens

Recommended Webinar for Staff Education

To support your quality improvement efforts, we encourage you and your teams to watch this short webinar on measles preparedness:

👉 Webinar: Measles Overview & Preparedness Strategies

Include this resource in your next staff meeting or circulate it through internal communication channels.

Final Notes for Practice Leaders

As your AHEC Practice Support team, we encourage practices to:

• Review vaccination outreach strategies for gaps
• Reassess triage and front‑desk screening workflows
• Reinforce airborne isolation procedures
• Ensure your team understands exposure timelines and reporting expectations
• Share this blog post with all team members, including supervisors and clinical staff

Measles remains highly preventable, and strong practice‑level systems make a meaningful difference in patient and community safety.

If you’d like help conducting a workflow assessment, staff training, or readiness review, your NC AHEC Practice Support coach is here to help.

North Carolina Medicaid is entering a major new chapter. Carolina Complete Health (CCH) and WellCare of North Carolina will officially merge into a single statewide health plan on April 1, 2026. The new combined plan will operate under the Carolina Complete Health name and will serve all six NC Medicaid regions.

As your Northwest AHEC Practice Support Team, we’re here to break down what this means for your practice, your teams, and—most importantly—the North Carolinians you care for.

Why This Merger Matters

This transition creates North Carolina’s largest Medicaid health plan, covering more than 775,000 members across the state. The unified plan continues as a Provider-Led Entity (PLE)—meaning North Carolina physicians retain a central governance role.

For practices, this means:

• Continued emphasis on provider voice in decision-making
• Streamlined processes under one statewide plan
• Reduced administrative duplication across CCH and WellCare products

Key Implementation Details You Need to Know

📅 Effective Date

April 1, 2026, unless NC DHHS issues updated guidance.

What This Means for Your Medicaid Patients

For current WellCare members

• Automatically transitioned to Carolina Complete Health
• No change in Medicaid benefits
• Will receive a new Member Welcome Packet and Member ID card
• Most members will keep their current primary care provider

For current Carolina Complete Health members

• Coverage expands statewide from 3 to 6 regions
• No change in Medicaid benefits
• New CCH Member ID card will be mailed as part of annual re-card
• Patients may keep their existing PCP

For Non-Members

Carolina Complete Health offers a free solution for payment by Electronic Funds Transfer (EFT) and Electronic Remittance Advice (835)/Explanation of Payment (ERA/EOP) through PaySpan®. If you are not already registered, create a new account by registering at payspanhealth.com or calling 1-877-331-7154, option 1.

For CCH providers

 The public website will remain https://network.carolinacompletehealth.com/. WellCare providers should begin using this webpage upon go-live (anticipated to be 4/1/2026) for updated materials (i.e. provider and billing manuals, contacts, and provider tools). 

What This Means for Your Practice

1. Contracting & Network Participation

• If your practice is contracted with either CCH or WellCare, you will remain contracted with the merged entity.
• To eliminate redundancy, the Medicaid product under WellCare agreements will be terminated as of April 1, 2026.
• Providers will continue serving:
  • Medicaid & Tailored Plan members through the CCH agreement
  • Medicare members through the WellCare agreement

If you received termination notices tied to the Medicaid product, these apply only to the WellCare Medicaid portion—not your overall WellCare contract.

2. Member Reassignment & Market Share

CCH has clarified:

• The new entity is not expected to exceed the market share cap
• Providers should not see large-scale member panel reassignment due to the merger

3. Billing, Claims & EFT/ERA

Frequently asked questions from providers include:

• EFT/ERA services will continue uninterrupted
• Claims for dates of service before April 1, 2026 will follow the originating agreement (CCH or WellCare)
• Claims on or after April 1, 2026 will process under the new CCH statewide plan

Updated provider manuals, billing guidance, and operations details will be posted on the official merger site as the go-live date approaches.

Operational Steps You Should Take Now

✔ Verify provider directory listings

Ensure your practice’s information is correct across:

• CCH Provider Directory
• WellCare Provider Directory

✔ Educate front‑desk and billing teams

Key items to emphasize:

• New member ID cards
• How to verify eligibility during the transition
• Which plan to bill based on date of service

✔ Review your contracts

Look specifically for:

• CCH agreement terms
• Any Medicaid-product termination notices from WellCare
• Tailored Plan participation details (if applicable)

✔ Monitor value-added service changes

Both CCH and WellCare note modifications coming to value-added services for 2026.

What Stays the Same

• Medicaid benefits for members
• Primary care provider assignments
• Commitment to provider-led governance
• NC Medical Society and NC Community Health Center Association remain partial owners of the Provider Led Entity (PLE)

Resources for Practice Managers

Here are the most relevant resources for keeping your team prepared:

Provider Merger FAQ (CCH Network Site)
https://network.carolinacompletehealth.com/merger.html

Member Merger Information (Public Site)
https://www.carolinacompletehealth.com/merger.html

Provider Services Contact:
1‑833‑552‑3876
NetworkRelations@CCH-Network.com

Northwest AHEC and the Office of Continuing Medical Education collaborate with state and local health associations, universities and community colleges, and hospitals and community organizations to serve constituents in the Northwest AHEC 17-county region and across the state. We offer educational activities designed to enhance knowledge and refresh clinical and professional skills.

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We value your feedback and planning for future activities will be based on your input, survey deadline is January 28^th.

What are the trends in AI use in health care settings?

A recent JAMA article examines AI use in health care since 2023, and compares the changes in health care settings to wider AI use trends.

To learn more, check out the ADL’s January 15 Highlighted Resource: Adoption of Artificial Intelligence in the Health Care Sector

NC Medicaid has announced important updates to coverage for Psychiatric Collaborative Care Management (CoCM) services, effective December 31, 2025. This change impacts both NC Medicaid Direct and NC Medicaid Managed Care programs.

Key Update: End-Dating of HCPCS Code G0512

The Healthcare Common Procedure Coding System (HCPCS) code G0512 will be end-dated on Dec. 31, 2025. This means Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) must transition to reporting CoCM services using individual CPT and HCPCS codes that previously comprised G0512.

Per Centers for Medicare & Medicaid Services (CMS) guidance, the following codes should now be used:

• 99492 – Initial psychiatric collaborative care management, first 70 minutes in the first calendar month.
• 99493 – Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities.
• G2214 – Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified healthcare professional.
• 99494 – Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month (up to four 30-minute sessions allowed per month).

Why This Matters

This update ensures alignment with CMS requirements and supports accurate reporting for CoCM services. Providers should review their billing practices and update systems to reflect these changes before the effective date.

Background

This bulletin serves as an update to the Sept. 17, 2025 bulletin on Psychiatric Collaborative Care Management coverage. NC Medicaid continues to emphasize integrated behavioral health care and collaborative models to improve patient outcomes.

Action Steps for Providers

• Discontinue use of G0512 after Dec. 31, 2025.
• Begin reporting CoCM services using codes 99492, 99493, 99494, and G2214.
• Ensure billing staff and systems are updated to comply with these changes.

For more details, visit the official NC Medicaid blog:
https://medicaid.ncdhhs.gov/blog/2025/12/30/updated-coverage-psychiatric-collaborative-care-management-december-30-2025

We’re excited to share a major development for rural health in North Carolina. Last week, the Centers for Medicare & Medicaid Services (CMS) approved North Carolina’s application for the Rural Health Transformation Program (RHTP)—a milestone that brings over $213 million in the first year to strengthen health care across our rural counties.

What Does This Mean for Your Practice?

• Significant Investment: The RHTP will support nearly 3 million rural North Carolinians and strengthen more than 400 rural health facilities statewide.
• Collaborative Approach: Implementation will involve state agencies, rural providers, community partners, academic institutions, and the private sector. This is a true team effort to improve health outcomes and care delivery.
• Governance and Regional Hubs: Once funding is received, NCDHHS will quickly establish a statewide governance structure and begin building regional hubs. Stakeholders—including practices like yours—will be engaged in funding and implementation decisions.

Get Involved: Virtual Town Hall

NCDHHS is hosting a virtual town hall to share program goals, next steps, and the anticipated statewide impact:

• Date: Friday, Jan. 16
• Time: 2:30–3:30 p.m.
• How to Join: Register using this link to attend via Zoom. You can also submit questions and join the RHTP mailing list during registration.

Why This Matters

• Expanded Resources: Expect new opportunities for funding, technical assistance, and collaboration to address rural health challenges.
• Practice Voice: Your input is needed! Participation in the town hall and ongoing engagement will help shape how resources are allocated and programs are implemented.
• Stay Informed: For updates and more information, be sure to opt in for the mailing list when using the registration link above.

Next Steps for Practice Managers

• Share this update with your teams and rural partners.
• Register for the town hall and encourage your staff to participate.
• Prepare questions or topics you’d like addressed—your feedback is essential.
• Watch for further communications from NCDHHS and our coaching team as implementation details emerge.

Happy New Year, North Carolina Practice Managers and Staff!

As we begin 2026, the landscape of childhood immunizations is shifting—bringing both confusion and opportunity for clarity. The latest update from the CDC, following a Presidential directive to align U.S. recommendations with “peer nations” like Denmark, has resulted in significant changes to the recommended vaccine schedule for children. Here’s what you need to know, and how to support your teams and families through this transition.

What’s Changed?

• Fewer Routine Vaccines: The CDC now routinely recommends vaccines for 11 diseases instead of 17. For example, the HPV vaccine moves from a 2-dose to a 1-dose schedule.
• Risk-Based & Shared Decision-Making: Several vaccines previously recommended for all children are now either:
  • Recommended only for high-risk groups: RSV (for children whose mothers didn’t get the pregnancy vaccine), Hepatitis A, Hepatitis B, Meningococcal.
  • Left to “shared clinical decision-making” (SCDM): Rotavirus, COVID-19, Influenza, Hepatitis A, Hepatitis B, Meningococcal. This means clinicians and families decide together, based on individual risk and benefit.
• No Change for Pediatric Vaccines Coverage: Medicaid and Prepaid Health Plans (PHPs) have not changed their position—coverage for pediatric vaccines remains unchanged at this time.

New HHS Childhood Immunization Schedule (Released January 5, 2026)

Key Points for Your Practice

1. Access Remains: Families can still access the full range of childhood immunizations recommended by the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP). The AAP schedule remains unchanged and is available .
2. No Out-of-Pocket Cost: All vaccines—including those now under SCDM—are still covered with no out-of-pocket cost by ACA-regulated private insurance, Medicaid, and the Vaccines for Children (VFC) program. HHS has affirmed this commitment.
3. Evidence Is Unchanged: The scientific evidence supporting the full AAP and AAFP vaccination schedules remains robust. These changes do not reflect new safety or efficacy concerns.
4. Anticipate Challenges: Expect confusion and operational challenges around school vaccine requirements, clinical workflows, and supply of combination vaccines. Clear communication and updated workflows will be essential.

Practical Guidance for Practice Managers & Staff

• Continue to Offer and Recommend Vaccines: Pediatricians and primary care teams can still offer vaccines according to the evidence-based U.S. schedule. Parents can request them, and clinicians should reassure families about continued access and coverage.
• Update Clinical Workflows: Integrate prompts and education into EHRs and point-of-care tools to maintain routine vaccination workflows and avoid missed opportunities.
• Communicate Clearly: Use talking points that focus on health outcomes (illnesses prevented, hospitalizations avoided) rather than the number of vaccines. Emphasize that fewer vaccines does not mean better health outcomes.
• Monitor for Policy Updates: Stay tuned for further guidance from NC Medicaid, VFC, and state health agencies. Forward any updates you receive to the NC Immunization Coalition (NCIC) and share with your teams.
• Educate Staff and Families: Address misconceptions proactively. For example:
  • The U.S. is not an outlier—most peer nations have schedules similar to ours, not Denmark’s.
  • The broader U.S. schedule exists to fill gaps in healthcare access and disease screening.
  • The Hep B birth dose is a critical safety net, especially given gaps in maternal screening and follow-up in the U.S.
  • Combination vaccines help reduce the number of shots, not the level of protection.

North Carolina Secures $213 Million to Transform Rural Health Care

We’re excited to share a major milestone for rural health in North Carolina. The Centers for Medicare & Medicaid Services (CMS) has approved North Carolina’s application for the Rural Health Transformation Program (RHTP), unlocking over $213 million in first-year funding to strengthen health care delivery across 85 rural counties.

This achievement reflects collaboration with more than 420 stakeholders, including rural hospitals, community health centers, local health departments, Tribal communities, and community- and faith-based organizations. It underscores North Carolina’s long-standing commitment to ensuring rural residents have access to high-quality, affordable care.

Why This Matters

North Carolina has the second-largest rural population in the nation, facing unique challenges in access, workforce, and infrastructure. The RHTP introduces six key strategies to address these needs:

• Expand behavioral health services
• Invest in the rural health workforce
• Improve prevention and chronic disease management
• Support providers transitioning to value-based care
• Enhance health care technology
• Launch NC ROOTS Hubs to connect medical, behavioral health, and social supports

What’s Next

Implementation will involve a broad coalition of state agencies, rural providers, community partners, academic institutions, and the private sector. Once funding is received, NCDHHS will:

• Establish a statewide governance structure
• Begin building regional hubs
• Engage stakeholders in funding and implementation decisions

To keep the conversation going, NCDHHS will host a virtual town hall on Friday, Jan. 16 to share program goals, next steps, and statewide impact. Details and registration will be available soon on the https://www.ncdhhs.gov.

Impact at a Glance

• Nearly 3 million rural North Carolinians supported
• More than 400 rural health facilities strengthened
• $213 million in federal investment for year one

This is a transformative moment for rural health in North Carolina, and we look forward to working together to make it a success.

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