JUNE 2026 ISSUE

QuitlineNC’s partnership with North Carolina Medicaid, housed in the Division of Health Benefits, began in 2008 with a Memorandum of Understanding (MOU) for Medicaid to help cover cessation counseling costs for Medicaid members. In 2011, following CMS authorization of Medicaid Match/Federal Financial Participation (FFP), the MOU was updated to reimburse QuitlineNC for 50% of actual counseling costs provided to Medicaid members. This funding mechanism remains in place today and provides an estimated $260,000 annually to support QuitlineNC services. 

From 2017–2019, North Carolina participated in two rounds of CDC’s 6|18 Initiative while preparing to transition Medicaid from fee-for-service to managed care. The NC Division of Public Health (DPH), Division of Mental Health/Developmental Disabilities/Substance Abuse Services, and NC Medicaid collaborated to strengthen tobacco treatment coverage and reduce barriers to cessation, particularly for people with behavioral health conditions. Strategies included tobacco-free campus policies, cessation action planning, barrier-free nicotine replacement therapy (NRT), and promotion of cessation services. Progress was slowed by the COVID-19 pandemic. A win includes making a COVID-era policy permanent, allowing tobacco treatment codes 99406 and 99407 to be billed using the GT modifier for telehealth services. 

In July 2021, North Carolina transitioned to Medicaid Managed Care, launching the Standard Plans and then in July 2024, the Tailored Plans. As of 2026, eight Managed Care Organizations (MCOs) serve Medicaid members statewide. Using CDC’s 6|18 Initiative as a framework, NC DPH and NC Medicaid incorporated key tobacco treatment strategies into broader interagency and managed care operations, including expectations for MCOs to:  

• Contract independently with North Carolina’s Quitline vendor (RVO Health)
• Cover enhanced cessation services, including behavioral health protocols and 8–12 weeks of NRT mailed to eligible members 
• Promote tobacco cessation services
• Submit annual Tobacco Cessation Plans 
• Develop plans for tobacco-free campus policies for Medicaid service sites, including behavioral health. Implementation of the tobacco-free campus policy requirement was later delayed and is currently voluntary but remains a priority long-term systems-change strategy.

Recent innovations, expanding QuitlineNC reach and engagement for Medicaid members: 

• Dedicated coordination: RVO Health created an NC MCO Coordinator position in 2024 to support collaboration with MCOs on service delivery, reporting, and outreach. Quarterly “QuitlineNC Partners Meetings” also bring together Public Health, MCOs, and other partners to share data, best practices, and emerging strategies.  
• Improved eligibility processes: Public Health and RVO Health strengthened intake procedures to better identify Medicaid MCO members, ensuring they receive enhanced services while preserving limited public health funding.  
• Unified branding and expanded resources: In July 2025, MCO services transitioned from RVO Health’s “Quit For Life” branding to the QuitlineNC brand. MCOs now have quick access to QuitlineNC promotional materials and coordinated messaging from QuitlineNC website to support outreach. Materials can be downloaded and printed. Note a redesigned QuitlineNC website is expected to launch late June 2026.  
• Targeted outreach: Several MCOs have enhanced outreach to perinatal populations. One MCO started a protocol requiring case managers to follow up with members enrolled in QuitlineNC, increasing the number of quit coaching sessions completed — a factor associated with higher quit rates. Case managers educate new parents about the importance of smoke-free homes and encourage household members who use tobacco, regardless of Medicaid status, to access QuitlineNC’s free quit support. 
• Aligned service offerings with the state: MCOs now have access to additional QuitlineNC services, including the Live Vape Free texting program for youth and young adults and menthol-focused educational resources. Public Health and MCOs now jointly promote these resources using coordinated materials and messaging. 
  

In calendar year 2025, QuitlineNC served 1,721 Medicaid MCO members and an additional 1,425 direct Medicaid members, supporting a total of 3,146 North Carolinians enrolled in Medicaid with tobacco treatment services.  


Public Health’s partnership with NC Medicaid, in collaboration with QuitlineNC’s vendor, continues to evolve through innovation, coordination, and continuous quality improvement — improving health outcomes for North Carolinians and extending the reach and sustainability of public health resources. 


To learn more, contact  Kim Bayha, Tobacco Cessation Director, NCDHHS, Division of Public Health, Tobacco Prevention and Control Branch at Kim.Bayha@dhhs.nc.gov.