Topics Related to Bulletins
Effective with date of service April 23, 2020, the Medicaid and NC Health Choice programs cover sacituzumab govitecan-hziy for injection, for intravenous use (Trodelvy™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
Effective with date of service Dec. 28, 2019, the Medicaid and NC Health Choice programs cover emapalumab-lzsg injection, for intravenous use (Gamifant™) for use in the Physician Administered Drug Program (PADP) outpatient hospital setting (only) when billed with HCPCS code J9210 - Injection, emapalumab-lzsg, 1 mg.
Effective with date of service April 7, 2020, the Medicaid and NC Health Choice programs cover meloxicam injection, for intravenous use (Anjeso™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.
Medicaid and NC Health Choice providers now have a single source to find answers to questions about COVID-19. The online resource is a collection of Medicaid and behavioral health COVID-19 information, including answers to questions received in the COVID-19 mailbox, during webinars, from COVID-19 Special Medicaid Bulletins and other sources.
Panelists will present a structured PowerPoint presentation focused on Appendix K and Retention Payments for the Innovations Waiver on Thursday, June 11, 2020, at 3 p.m.
In December 2019, DHHS released the draft Tailored Care Management Provider Manual and application questions for providers interested in becoming Advanced Medical Home Plus practices or Care Management Agencies. The Department received many thoughtful comments on the draft Provider Manual and has made several updates.
North Carolina is experiencing increased community transmission of COVID-19 in many areas of the state, particularly among our historically marginalized populations, especially our Latinx community. Pre-symptomatic and asymptomatic spread is playing an important role. Updated clinician and laboratory testing guidance and a new resource on community testing in historically marginalized populations are available.
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.