Topics Related to Bulletins
The Department has decided to further extend the initial application deadline for providers from Feb. 21, 2020 to June 2020 (date TBD).
While the implementation of managed care has been suspended as legislative action is needed to move forward, the Department of Health and Human Services continues to work on the design of Standard Plans and Behavioral Health and Intellectual Developmental Disability (I/DD) Tailored Plans. The Department is releasing a Behavioral Health Crisis System Memo for Standard Plans.
Effective with date of service April 15, 2020, the Medicaid and NC Health Choice programs cover trastuzumab-dttb for injection, for intravenous use (Ontruzant®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code Q5112 - Injection, trastuzumab-dttb, biosimilar, (Ontruzant®), 10 mg.
Effective July 26, 2020, changes will be made to initial enrollment, re-enrollment, re-verification applications and manage change requests (MCRs) for individual providers (excluding disaster relief and Out of State Lite providers). The updates include the addition of a new page, as well as additional exclusion sanction questions.
NC Medicaid will allow temporary changes to Clinical Coverage Policy 12B for Written Physician Orders, Use of Remote Technology and Signature Requirements.
Beginning June 2020, the Remittance Advice will include a detailed explanation of any refund (Lump Sum / Miscellaneous Payment) issued to the provider. This message will be on the Financial Transactions page.
NC Medicaid is temporarily increasing the number of therapeutic leave days for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IIDs) from 60 days to 120 days. This is a change from the previous increase to 90 days. NC Medicaid continues to waive the requirement of approval needed for more than 15 consecutive days per Clinical Coverage Policy 8E.
Program Year 2019 is Closed, NC-MIPS is Open for Program Year 2020, Program Year 2020 Webinar Series and The Security Risk Analysis (SRA).
NOTE: UPCOMING PROVIDER WEBINAR
NC Medicaid COVID+ Rate Reporting Technical Assistance Session
Wednesday, June 3, 1:00 p.m.
Register
NC Medicaid is implementing a targeted rate increase and additional billable hours for State Plan and CAP/C and CAP/DA In-Home Personal Care Service (PCS) providers for direct service to a COVID-19-positive (COVID+) beneficiary. This bulletin:
NC Medicaid COVID+ Rate Reporting Technical Assistance Session
Wednesday, June 3, 1:00 p.m.
Register
NC Medicaid is implementing a targeted rate increase and additional billable hours for State Plan and CAP/C and CAP/DA In-Home Personal Care Service (PCS) providers for direct service to a COVID-19-positive (COVID+) beneficiary. This bulletin:
Effective Sunday, May 31, 2020, NC Medicaid is terminating the auto approval for lung imaging requested through EviCore, NC Medicaid’s contracted vendor for imaging services.