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N C DMA PMH CCNC OB Workgroup Meeting Agenda, December Ncdhhs Form
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People also ask
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What is the maximum income to qualify for Medicaid in NC?
A pregnant person may be eligible if the family income is $6,854/month or less (includes one unborn child). A child ages 0-18 may be eligible if the family income is $6,432/month or less. An adult ages 19-64 may be eligible if the family income is about $4,207/month or less.
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What is included in a drug utilization review?
DUR is classified in three categories: Prospective - evaluation of a patient's drug therapy before medication is dispensed. Concurrent - ongoing monitoring of drug therapy during the course of treatment. Retrospective - review of drug therapy after the patient has received the medication.
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What is the NC Medicaid drug utilization review program?
The NC Medicaid Drug Utilization Review (DUR) program for outpatient drugs ensures Medicaid recipients receive appropriate, medically necessary prescriptions that are unlikely to result in adverse medical events. NC DUR Board meetings are held quarterly.
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What is the pregnancy management program in NC?
Care Management for Pregnancy is a statewide program in North Carolina. Services are available at no cost to pregnant women enrolled in Medicaid, and to a limited number of uninsured pregnant women. A Care Manager will work closely with you and your prenatal care provider to meet your needs during your pregnancy.
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What is a PBM for Medicaid NC?
NC Medicaid Managed Care PBMs are the fiscal agent for pharmacy benefits for our managed care plans. For example, they pay pharmacy claims for beneficiaries enrolled in managed care plans, similar to NC Medicaid "POS" vendor for Medicaid Direct.
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What is the difference between dur and due?
Drug Utilization Reviews (DUR), also referred to as Drug Utilization Evaluations (DUE) or Medication Utilization Evaluations (MUE), are defined as an authorized, structured, ongoing review of healthcare provider prescribing, pharmacist dispensing, and patient use of medication.
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