North Carolina is developing plans to implement Medicaid provisions from the 2025 reconciliation law while facing budget constraints. The state is preparing policy changes that will affect Medicaid coverage and beneficiary access to care. Implementation details are emerging as North Carolina managed care organizations and state officials work through operational and financial implications. The reconciliation law's Medicaid provisions, combined with state budget pressures, will require MCOs to adjust operations, network management, and benefit administration.
Managed Care · Finance
The National Academy for State Health Policy published findings from a two-year collaborative examining how states expand Medicaid access for individuals reentering communities after incarceration. The report highlights state approaches to enrollment, care coordination, and coverage continuity during the transition from correctional facilities. States face operational challenges linking justice systems with Medicaid eligibility systems and coordinating behavioral health and substance use disorder services. The work is relevant for MCOs operating in states implementing reentry initiatives, which may require dedicated care management protocols and cross-agency data sharing.
Behavioral Health · Managed Care
The National Academy for State Health Policy will hold a webinar on June 25, 2026, from 1–2 p.m. ET focusing on how states use prescription drug cost data to inform policy decisions. The session will examine state-level approaches to managing pharmaceutical spending. For Medicaid managed care organizations, state prescription drug cost initiatives can lead to new reporting requirements, formulary restrictions, or supplemental rebate negotiations that affect pharmacy benefit management and claims administration.
Pharmacy · Managed Care