Evolent handles the prior authorizations for Carolina Complete Health members and have updated their prior authorization list for DOS effective April 1,2026 and going forward.

The following radiology procedures and diagnostic cardiology procedures will no longer require an auth.

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• Carolina Complete Health: radiology and diagnostic cardiology prior auth update
• NYS Medicaid: existing policy reminder coverage for SD/ED
• Carolina Complete Health: co-pays for pregnant members info
• HEDIS Measure: Lead Screening in Children (LSC)
• NYRx (Medicaid): no coverage for certain medications