New legislation extends Medicaid for pregnant Beneficiaries to 12 Months after birth - effective April 1, 2022.

Effective April 1, 2022, NC Medicaid coverage for pregnant beneficiaries will extend to the last day of the month in which the 12-month postpartum period ends. The change is made pursuant to NC Senate Bill 105 Session Law 2021-180 Section 9D.13 and the American Rescue Plan Act of 2021. These laws are in effect through March 31, 2027.

• All Medicaid beneficiaries who are pregnant and have benefits in a program that covers the birth of the child will be able to access full coverage Medicaid benefits for the duration of pregnancy and the extended 12-month postpartum period. For example, Medicaid for Pregnant Women (MPW) will now cover dental services for the full 12-month postpartum period after the day of delivery.
• Prior Authorization guidelines currently in place to limit services related to pregnancy and to other conditions that may complicate pregnancy will be removed.

Beneficiaries who are in their current 60-day postpartum period on April 1, 2022, will be extended for the remainder of the 12-month period following the date the pregnancy ends.

Coverage for the 12-month postpartum extension does not apply for those beneficiaries with Emergency Medicaid.

A future Medicaid provider bulletin will be published once the 1E-5, Obstetrical Services Policy is finalized and posted.

Contact

NCTracks Contact Center: 800-688-6696