February is American Heart Month

A time to raise awareness about cardiovascular disease

There are a LOT of things you can do to help protect your heart including self-care activities like physical activity, eating healthier foods, getting enough sleep, not smoking, and finding healthy ways to reduce stress according to the National Heart, Lung, and Blood Institute.

According to a study done in 2023 by the CDC there are 632,000 North Carolinians that have coronary heart disease which is the most common form of heart disease. This disease can be prevented by having a healthier lifestyle which includes moving more, eating healthier, getting enough sleep, quitting smoking and reducing stress.

The CDC contributes High Blood Pressure as being a leading cause of heart disease with just 1 in 4 people with High Blood Pressure having it under control. See below in the Training and Resource section for resources on controlling blood pressures and best practices for taking blood pressures.

The best way to be heart smart is to know what the normal ranges are for things like cholesterol, blood pressure, and physical activity. Adults should have a total cholesterol below 200mg/dl to be considered in normal heart healthy range. Normal blood pressure for an adult is 120/80 and an adult should have 75-150 minutes of physical activity a week to optimize heart health. The best activities to promote heart health include running or walking, swimming, yoga, cycling, and weight training.

Hello Heart is a new benefit for Rural Members of NC State Health Plan. Hello heart is the digital leader in preventive heart health and empowers members to better understand and improve their heart health. The program will be available to members that work for selected organizations and are experiencing hypertension, high cholesterol, menopause or other heart disease risk factors. Members of the State Health Plans can sign up for Hello Heart for no cost to them. The members will be equipped with a connected blood pressure monitor and app to track measures like blood pressure, cholesterol, weight and activity levels from the comfort of their homes.

Medicaid Updates

Medicaid Rate Reduction Reversal Update – On December 10, 2025, North Carolina announced that previously implemented Medicaid reimbursement rate reductions effective October 1, 2025, will be reversed. The state is restoring reimbursement levels to the rates that were in effect prior to October 1, 2025.

Updated NC Medicaid Direct fee schedules are expected to be published on January 5, 2026, through the Department’s Fee Schedules and Covered Codes Portal. Following publication, health plans will have up to 45 days to update their systems with the revised rates. Once updates are complete, plans will have an additional 30 days to reprocess eligible claims with dates of service on or after October 1, 2025

Medicaid Reinstitutes Coverage for GLP-1s for Weight Management – On December 12, 2025, Medicaid reverted coverage for GLP-1 as a treatment for obesity and weight management to their previous coverage available as of September 30, 2025.

Medicaid Member Ombudsman Program – The contract between the Member Ombudsman and Legal Aid of North Carolina (LANC) concluded on December 31, 2025, and will not be renewed. The Member Ombudsman will continue but with reduced services and will be operated under the North Carolina Department of Health and Human Services, Division of Health Benefits (NC Medicaid) on January 2, 2026. The change does not impact the Medicaid Provider Ombudsman Program.

NC Medicaid is hosting a Virtual Office Hours on February 5th and a Back Porch Chat on February 19th. Click here to register.

NC Medicaid PHP Incentive Program Comparison 2026

WellCare and Carolina Complete Health Merger – AHEC has broken down the merger and what to expect. Carolina Complete Health and WellCare of North Carolina will officially merge into one plan on April 1, 2026. The new combined plan will operate under Carolina Complete Health (CCH) and will be available and serve all 6 Medicaid regions. The combined plan will continue as a Provider-Led Entity (PLE) – meaning that North Carolina physicians retain a central governance role.

For patients with WellCare they will automatically be transitioned to Carolina Complete Health with no change in their Medicaid benefits. The patients will receive a new welcome packet and card once the merger is complete. Most patients will be able to keep their current primary care providers.

For patients with Carolina Complete the coverage will now be available in region 3 and 6 with no change in their current Medicaid benefits. They will also receive a new member ID card and be able to keep their existing primary care provider.

For Practices that are already contracted with either CCH or WellCare will remain contracted through the merged entity. To eliminate redundancy, the Medicaid product under WellCare agreements will be terminated as of April 1, 2026. There is nothing practices will have to do if they are already contracted with either CCH or WellCare.

What’s Going On!

UHC Medicare Advantage Patients

Patients that have UnitedHealthcare Medicare Advantage will be required to receive a referral from their Primary Care Provider (PCP) before receiving certain specialist services in a outpatient, office or home setting. The referrals will need to be submitted to UnitedHealthcare prior to the specialist visit. UnitedHealthcare will enforce this policy starting May1,2026 where if there is no referral submitted for specialist services, they will deny the claim.

Measles

• NC DHHS recorded webinar on measles

• Updated Information on Measles

Pediatrics

• The CDC has released updates to the recommended U.S. Childhood Immunization Schedule. At this time, there are no changes in coverage position by Medicaid or Prepaid Health Plans (PHPs) related to pediatric vaccines. The American Academy of Family Physicians (AAFP) has issued a statement regarding the CDC’s recommended changes, emphasizing that “vaccines remain our single best defense against preventable disease. The evidence hasn’t changed, so the AAFP’s recommendations haven’t changed. Vaccines save lives.

• Changes to the U.S. Childhood Immunization Schedule

• Potential Impacts – US Vaccine Policy Changes

• Updated Danish Vaccine Schedule – The Evidence Collective

Rural

• North Carolina’s application for Rural Health Transformation Program (RHTP) was approved, meaning that the state will receive over $213 million for the first year of the program.

• Virtual Office Hours for RHTP held on January 16, 2026

• State Designated Rural Health Centers Support Grant Requests for Applications for 2027

Trillium Provider Network Transition

• Trillium has announced that effective July 1, 2026, they will be transitioning their physical health and Long-Term Services and Supports (LTSS) contracting away from Carolina Complete Health and will instead be directly managing the physical health network, including claims processing and provider relationships.

 

Practice Manager Bootcamp

Course: Leadership 

Practice managers are leaders, and the better leaders they are, the more successful their practices will be. In this course, you will learn communication and management skills that will help you make your practice cohesive, efficient, and welcoming for both your staff and patients.

When: March 12, 2026 – April 13, 2026

Location: Live Webinar

Cost: $100.00

Register Here

Course: Quality Improvement 

Practice managers are leaders, and the better leaders they are, the more successful their practices will be. In this module, you will learn communication and management skills that will help you make your practice cohesive, efficient, and welcoming for both your staff and patients.

When: April 23, 2026 – May 14, 2026

Location: Live Webinar

Cost: $80.00

Register Here

NCTracks

February 2026 Provider Training Schedule

Registration is open for the Feb. 2026 training courses listed below. NCTracks zoom courses can be attended remotely from any location. Courses offered this month include:

• Submitting an Institutional Claim

• Prior Approval Medical

• Submitting a NEMT Claim

• Submitting an Ambulance Claim

• Dental Helpful Hints

• Enrollment Specialist User Role Abbreviated MCR/ Upload Docs

See the document linked below for more information on course schedule and access to zoom links: Feb. 2026 Provider Training Schedule

Continuing Professional Development

ACES Too High: Prevention and Intervention Strategies to Address Trauma and Reduce Health Disparities

February 5, 2026

Live Webinar

Heart Disease in Women – Unique Risk Factors and Presentation

February 5, 2026

Live Webinar

2026 NC AHEC Academic Profession Conference

February 6, 2026

Live Webinar

Basic IV Clinical Skills Workshop

February 11, 2026

In-Person – Fayetteville, NC

16th Annual Teen Summit: Supporting Students Impacted by Systemic Barriers

February 16, 2026

In-Person – Fayetteville, NC

Heart Disease in Women – Prevention, Lifestyle Modification, and Long-Term Management

February 19, 2026

Live Webinar

4th Annual Southern Regional NC OB/GYN Conference

February 20, 2026

In-Person – Fayetteville, NC

Colloquium on Interdisciplinary Care for Parkinson’s: Building Your Team, Enhancing Your Care

February 20, 2026

In-Person – Fayetteville, NC

Results-Based Accountability – Redefining Success and Measuring Impact

February 24, 2026

In-Person – Charlotte, NC

Maternal & Behavioral Health Integration

February 27, 2026

Live Webinar

Wound Care Certification Prep Course

February 26, 2026 – February 27, 2026

In-Person or Live Webinar – Fayetteville, NC