Topics Related to Bulletins

This article is a reminder to providers of the process for submitting requests for Disproportionate Share Hospital data. Medicaid and NC Health Choice Providers must request and obtain batch Medicare DSH Recipient Eligibility Verifications and Provider Statistical and Reimbursement reports through NCTracks.

We know these are challenging times and are grateful for the continued support of our partners across the state. There is a wealth of information on the DHHS website and our team is working around the clock to make it as user-friendly as possible.

NC Medicaid is committed to ensuring our beneficiaries continue to receive Medicaid and NC Health Choice services with no interruptions or delays due to the novel coronavirus (COVID-19) outbreak.

Effective with date of service Dec. 31, 2019, the Medicaid and NC Health Choice programs cover enfortumab vedotin-ejfv for injection, for intravenous use (Padcev) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Effective with date of service Jan. 6, 2020, Medicaid and NC Health Choice programs cover fam-trastuzumab deruxtecan-nxki for injection, for intravenous use (Enhertu) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Effective March 1, 2020, Medicaid will begin issuing letters to PDN agencies addressing non-compliance with the timely submission of required documentation as indicated in the Request for Additional Information notice. 

NC Medicaid is committed to ensuring our beneficiaries continue to receive Medicaid and NC Health Choice services with no interruptions or delays due to the novel coronavirus (COVID-19) outbreak. A webcast has been scheduled to discuss temporary modifications to certain policies and provide related billing codes. 

The department is releasing a Behavioral Health Crisis System Memo for Standard Plans

The Department has extended the public comment period for the Behavioral Health I/DD Tailored Plan Request for Applications Pre-Release Policy Paper published on Jan. 30, 2020.

NC-MIPS is Open for Program Year 2019; The Security Risk Analysis (SRA); Reminder from CMS Regarding Objective 6 and Objective 7; Clarification from CMS Regarding Objective 5 Measure 1: Patient Electronic Access and General Reminders.