From NC Medicaid:

Children & Families Specialty Plan

The Primary Care Provider (PCP) contracting deadline for Beneficiary Choice Period is September 1, 2025.

The Children and Families Specialty Plan (CFSP) is a single, statewide NC Medicaid Managed Care health plan designed to support children, youth and young adults currently and formerly served by the child welfare system. Sept. 1, 2025, is the last day for PCPs to have fully executed contracts with the CFSP for inclusion at the start of the Beneficiary Choice Period.  Go Live Date is 12/1/25. 

Providers who wish to participate in CFSP should contact Health Blue Care Together to discuss the contracting process and requirements.

For inquiries, please use the following contacts:

Email:

• Contracting Inquiries: NC_Contracting@healthybluenc.com
• General Questions and Comments: NC_Provider@healthybluenc.com

Phone:

1-844-594-5072

For more details on the CFSP, including eligibility, covered services and updates, please visit our Children and Families Specialty Plan website. You can also find more information by reviewing the What Providers Need to Know fact sheet.

From 2000-2023, more than 41,500 North Carolinians lost their lives to a drug overdose. Each day in 2023, 12 North Carolinians died from a drug overdose. Recent year death data is not yet final, but an estimated 3,025 North Carolinians (8 per day) are suspected to have died from an overdose in 2024.

Overdose does not discriminate.

One important way you can help is to have Naloxone on hand, ensure it is available to your patients and their families, and educate yourself, your staff, and people you care about, how Naloxone saves lives.

A person with a substance use disorder cannot begin recovery if they are not alive!

Who should have Naloxone on hand?

In 2018, United States Surgeon General, Dr. Jerome Adams, issued a public health advisory emphasizing the importance of naloxone in savings lives. In this advisory, he recommended the following groups of people carry naloxone and know how to use it:

• Individuals taking high doses of opioids as prescribed for the management of chronic pain
• Individuals taking prescription opioids concurrently with alcohol or sedating medications (i.e. benzodiazepines)
• Individuals misusing prescription opioids or using illicit opioids such as heroin
• Individuals with a history of opioid use disorder
• Individuals completing opioid detoxification
• Individuals recently discharged from emergency medical care following an opioid overdose
• Individuals recently released from incarceration with a history of opioid use disorder
• Family and friends of people who have opioid use disorder
• Community members who come into contact with people at risk for opioid overdose

Learn more here:

Responding to an Opioid Overdose

Source: https://naloxonesaves-nc.org/safer-use-and-overdose-prevention/what-is-naloxone/

https://naloxonesaves-nc.org/

Date: August 26, 2025

Time: 12:00 - 1 p.m.

The Statewide Health Information Exchange Act was passed in 2015 by the North Carolina General Assembly.  This legislation paved the way for a statewide health information exchange (HIE), now known as NC HealthConnex.

NC HealthConnex is a valuable tool to support care improvement efforts.  In the context of value-based care, providers need access to timely, accurate clinical data to track outcomes and coordinate care effectively.  By its very definition, value-based care requires visibility into a patient's full journey across the care continuum.

Real-time, reliable clinical data is a critical tool for delivering appropriate care and closing information gaps. NC HealthConnex supports this by offering services that allow providers to:

• Query patients,

• Receive Admission, Discharge and Transfer notifications, and

• Send encrypted messages to other providers involved in a patient’s care.

NC Medicaid’s transition to NC Medicaid Managed Care, the launch of Tailored Care Management, and Medicaid Expansion make NC HealthConnex services an increasingly valuable follow-up tool for providers. The North Carolina Health Information Exchange Authority (NC HIEA), the state  agency that oversees NC HealthConnex, and NC Medicaid have built a strong partnership, collaborating through NC Medicaid Managed Care launch and the COVID-19 pandemic. Today, they are working together on a series of use cases that leverage NC HealthConnex to support NC Medicaid’s quality and population health goals.

In this session, speakers will explain how NC HealthConnex works, review available services, and provide a live demonstration of the NC HealthConnex Clinical Portal. They will also highlight current innovations stemming from the collaboration between NC Medicaid and the NC HIEA. Attendees will leave with an understanding of how NC HealthConnex and its services can serve as valuable tools to support high-quality, coordinated patient care.

At this time, there’s been no indication that the Clear Pricing Project (CPP) will be extended or replaced for primary care. The only new program announced so far is the Behavioral Health Access Program (BHAP), which does not apply to primary care providers.

That said, here are a few proactive steps you can take:

• Review your current contracts with Aetna to understand how your reimbursement rates may change once CPP ends.
• Consider renegotiating your contract. Many practices are already doing this to secure more sustainable terms.
• Ensure you’re part of Aetna’s Choice POS II network, which the NC State Health Plan will use exclusively starting January 1, 2025.
  
  👉 Join the Aetna Network
  👉Behavioral Health Access Program(BHAP)

MEDICAID MANAGED CARE

Disaster Preparedness for Members with Chronic Conditions

August 19 | NOON - 1 p.m.

Please join us for the last webinar in this series focused on disaster preparedness for members with chronic conditions.  This webinar will cover the following:

• Long term recovery considerations
• Behavioral Health impacts
• Finding resources
• Crisis Services
• Hope 4 NC
• Understanding Resilience
• Building Resilience

Register by clicking the button below. We look forward to connecting with you!

Their behavior may become increasingly confrontational as a result.

Healthcare settings are places of intensified emotion.

How well do you and your staff respond to escalating confrontational behaviors from patients and their families?

A new toolkit from NCDHHS offers a variety of resources to support healthcare providers with giving vaccines. The information and tools address the challenges involved in providing vaccines, including conversation guides, communication tools, and population-specific guidance.

Save the Date!

Fifth Annual Virtual Statewide Quality Forum

October 8, 2025 | noon - 1 p.m.

The North Carolina Department of Health and Human Services Division of Health Benefits and North Carolina AHEC, in conjunction with the five Medicaid managed care standard plans, will host the Fifth Annual Virtual Statewide Quality Forum on October 8 from noon-1 p.m. Topics will include:

• Simplification Updates
• Key Developments on NC Division of Health Benefits
• Key Developments on 2026 Advanced Medical Home Measures and Benchmarking Approach
• Key Developments on NC HealthConnex Updates
• Screen Early, Optimize Health: Proven Strategies for Success

The forum is designed to help providers, practice managers, and quality managers succeed with Medicaid Managed Care quality initiatives. Look for additional details, including how to register, soon.

We hope you can join us!

The answer is The Hepatitis Virus.

Hepatitis is also the leading cause of liver cancer!

World Hepatitis Day is July 28th

What is Hepatitis? 

An inflammation of the liver, most commonly caused by a viral infection. There are five main hepatitis viruses (A, B, C, D and E). These are of greatest concern because of the burden of illness and death they cause, and the potential for outbreaks and spread.

Different Types of Hepatitis:

A: Primarily spread when an unvaccinated person ingests food or water that is contaminated with the feces of an infected person. Does not usually cause chronic liver disease. Closely associated with unsafe water or food, inadequate sanitation, poor personal hygiene, and oral/anal sex. An effective vaccine is available.

B: Spread when an unvaccinated person is exposed to infected blood or body fluids from an infected person, including from infected mother to child at birth. A safe and effective vaccine offers 98-100% protection. Potentially life-threatening liver infection and a major global health problem. Puts people at high risk of death from cirrhosis and liver cancer.

C: As a bloodborne virus, Hepatitis C is most commonly spread through sharing needles when injecting drugs, and through sexual contact. If appropriate practices are not followed, it can also be spread via inadequate sterilization of medical equipment in healthcare settings or transfusion of unscreened blood / blood products. There is no effective vaccine against hepatitis C.

D: Infection with this strain cannot occur in the absence of hepatitis B. This co-infection is considered the most severe form of chronic viral hepatitis due to faster progression to cancer and liver-related death. Vaccination against Hepatitis B is the only way to prevent hepatitis D infection.

E: Most commonly found in countries with limited access to essential water, sanitation, hygiene and health services. (Some outbreaks have occurred in war zones and camps for refugees or internally displaced populations.) This virus is shed in the stools of infected persons and enters the human body through the intestine. A vaccine to prevent this strain is licensed in China but is not yet available elsewhere.

Did you know.......

Medicare covers Hepatitis B Screening, Hepatitis B immunization and administration, and Hepatitis C Screening ? (It also covers HIV Screening, and since HIV is also a blood-borne virus often associated with hepatitis viruses, can be transmitted through sexual contact,  (seniors ARE sexually active), it is important to offer this as well.)

Sources:

Medicare Preventive Services Quick Reference Chart

World Hepatitis Day

Are you a healthcare professional passionate about providing the best care for children? Don’t miss the opportunity to enhance your knowledge and earn contact hours with our Pediatric Pulse Live Webinars—a dynamic series designed to keep you informed on the latest in pediatric healthcare.

Each webinar offers 2 contact hours and delivers essential updates on timely topics in pediatric care. Whether you're a nurse, physician, or allied health professional, these sessions are crafted to support your clinical practice and deepen your understanding of complex pediatric issues.

🧬 August 12, 2025 | 11AM–1PM 

Caring for Children with Genetic Conditions & Their Families

This insightful session will explore:

• The incidence and pathophysiology of selected pediatric genetic conditions
• Clinical priorities in managing these conditions
• The ethical, legal, and social implications of genetic diagnoses
• Strategies for family-centered care and compassionate communication

You’ll leave equipped with evidence-based tools to support children and families navigating the challenges of genetic disorders.

👉 Register Now - https://northwestahec.wakehealth.edu/t3/courses-and-events/75876/pediatric-pulse-caring-for-children-w-genetic-conditions-their-families

💉 September 11, 2025 | 11AM–1PM

Vaccines and Immunizations: What Every Pediatric Provider Needs to Know

Stay current with:

• The latest vaccine recommendations and immunization schedules
• Clinical indications for various pediatric vaccines
• How to address vaccine hesitancy with empathy and evidence
• Tools for effective communication with parents and caregivers

This session empowers you to be a confident advocate for immunization in your community.

👉 Register Now - https://northwestahec.wakehealth.edu/t3/courses-and-events/75872/pediatric-pulse-vaccines-and-immunizations

🎓 Why Attend?

• Earn 2 contact hours per session
• Learn from expert presenters in pediatric care
• Gain practical strategies for real-world application
• Participate in live Q&A and interactive discussions

Don’t miss this chance to sharpen your skills and stay informed on the latest in pediatric healthcare. Register today and be part of a community committed to excellence in caring for children.