Each month I round up the billing, coverage, and policy changes most likely to land on your desk as a North Carolina behavioral health practice owner. Here's what's worth knowing this October (and what to do about it).
The DEA telehealth prescribing deadline
The DEA's temporary rules that let prescribers start controlled medications, including ADHD stimulants, over telehealth without an in-person visit are set to expire December 31, 2026. They've been extended four times before, but no permanent rule has been finalized yet. Even if your practice doesn't prescribe, your clients may see a telehealth-only prescriber, so it's a good time to update your list of local prescribers who see people in person.
ADHD medication shortages
The FDA listed shortages of Adderall and methylphenidate in June, and manufacturer recovery estimates range from this month to January 2027. Make sure your front desk and clinicians know the basics: clients can call pharmacies ahead and ask their prescriber about other strengths or formulations.
NC Medicaid changes
Since October 1, eligibility is narrower for some non-citizens. On January 1, 2027, expansion adults ages 19 to 64 will face work requirements and six-month renewals (some groups are exempt). Expect more coverage gaps, so check eligibility before every session, not just at intake, and review your self-pay and coverage-lapse policies. Clients can check whether they're affected at medicaid.nc.gov/changes.
Marketplace open enrollment
Open enrollment runs November 1 through December 15 this year, a month shorter than before. NC insurers have requested 2027 individual-plan increases averaging around 15%, and Cigna is leaving the NC individual market on January 1. Plan to collect new insurance cards and run eligibility checks before your first January sessions.
New rural mental health funding
On October 7, NC announced about $17.7 million for rural mental health, covering CCBHCs, youth mobile crisis teams, first-episode psychosis care, opioid treatment, and NC MATTERS perinatal psychiatry access. If you serve rural North Carolina, these programs are worth knowing as referral partners and crisis resources.
Want help getting your practice ready for any of this? Book a free 15-minute intro call and we'll talk it through.