Frequently Asked Questions
Who can I call about my pharmacy benefits?
Effective May 2, 2026, pharmacy benefit inquiries for NC Medicaid Direct beneficiaries should be directed to the Prime Call Center at 844-620-6116.
Is Prime a PBM?
No. Prime serves as the Pharmacy Benefit Administrator (PBA) for NC Medicaid Direct. The State retains ownership and oversight of pharmacy policy, reimbursement and formulary decisions.
How do I request a new or replacement pharmacy ID card?
For replacement or new Medicaid ID cards, please contact the Department of Social Services (DSS) at 888-245-0179.
Do these FAQ's apply to NC Medicaid Direct only or also to Health Plan (PHP) beneficiaries?
These FAQ's apply to NC Medicaid Direct beneficiaries. Pharmacy benefit questions for beneficiaries enrolled in PHP should be directed to the beneficiary’s health plan.
Is the Pharmacy PA Call Center open on holidays?
Yes. The Pharmacy PA Call Center operates 24 hours per day, 7 days per week, 365 days per year, including NC State-observed holidays. Phone: 844-620-6116 Fax: 866-422-8981 (Effective May 2, 2026).
Are documents with private beneficiary information privately stored at Prime Therapeutics?
Yes. Prime maintains protected health information (PHI) in accordance with HIPAA, state privacy laws, and contractual data security requirements.
Why are these drugs singled out for prior authorization?
Certain medications are subject to PA based on clinical guidelines, cost considerations, utilization management standards, and program policy to ensure appropriate and medically necessary use.
Where can I get the PA criteria?
All PA criteria and associated forms will be available on the Prime PBA website under the Forms and Documents section.
How are providers notified of updates to the program?
Program updates are communicated through NC Medicaid bulletins and posted on the Prime PBA website. Providers are encouraged to monitor the website regularly for the most current information.
Are medications dispensed in the doctor's office and by home health care providers subject to PA?
Prescription drugs billed through the NC Medicaid Pharmacy Program are subject to PA requirements as applicable. Medications administered in a prescriber's office that are billed under the medical benefit are to processed through the Pharmacy program. IV medications administered in the home and certain drugs dispensed to nursing facility residents may be covered under the Pharmacy Program and may therefore require PA.
Does a Prior Authorization (PA) guarantee payment?
No. Prior Authorization confirms medical necessity and policy compliance at the time of review. It does not guarantee payment. Final claim adjudication remains subject to beneficiary eligibility, benefit coverage, and all other applicable program requirements at the time the claim is submitted.
Can a prescriber request medical profile information on a beneficiary while on the phone (e.g., what other medications the beneficiary is currently taking)?
Prime representatives may access claims history information for treatment and operational purposes in accordance with HIPAA and program guidelines. Information may be shared with the prescriber or authorized representative as permitted by law.
What happens to existing prior authorizations at go-live?
Prior authorizations approved prior to the transition will remain valid through their original approval period.
Can a prescriber’s nurse or office manager call in a PA request?
Yes. A prescriber may designate a beneficiary of their clinical staff (e.g., nurse or office staff) to submit or call in a PA request. The prescriber remains responsible for the accuracy and completeness of submitted information.
Can pharmacists initiate PAs?
No. A dispensing community pharmacist may not initiate a PA request. If a claim rejects for PA, the pharmacist must contact the prescriber to initiate the request. Pharmacists may contact the Prime Call Center at 844-620-6116 to check the status of a submitted PA.
Can a Long Term Care Pharmacy who maintains a beneficiary chart, initiate the PA?
A LTC pharmacy may initiate a PA request for NC Medicaid Direct beneficiaries for all drugs except Brand Name Schedule II (CII) narcotics and sedative hypnotics, in accordance with program policy.
Who completes the PA form, the discharging physician or home care unit?
The PA request should be submitted by the prescribing provider responsible for the medication order. An authorized representative may submit the request on the prescriber's behalf if all required clinical information is available.
Is the Physician signature necessary on the PA form?
When a PA request is submitted via fax or paper form, it must include the signature of the prescribing provider or their authorized representative, as required by program policy.
Can a prescriber initiate a PA request before the beneficiary arrives at the pharmacy and receives a claim reject?
Yes. A prescriber or authorized representative may submit a PA request to Prime prior to the beneficiary presenting at the pharmacy and prior to a claim rejection.
Must the RX copy accompany the PA request form?
No. A prescription copy is not required to accompany the PA request unless specifically requested during review.
What is the fastest way to receive a PA outcome for a prescriber?
The fastest and preferred method to receive a PA determination is to submit the request through the secure Prime Provider Portal.