Effective July 1, 2019, NC Medicaid will make changes to the North Carolina Medicaid and NC Health Choice Preferred Drug List.
Topics Related to Bulletins
Registration is open for the July 2019 instructor-led provider training courses. Slots are limited.
New or amended clinical coerage policies are available on NC Medicaid's website.
NC-MIPS is Open for Program Year 2019. The NC Medicaid EHR Incentive Payment System (NC-MIPS) is only accepting Program Year 2019 Stage 3 Meaningful Use (MU) attestations.
The Contract for Prepaid Health Plan Services (the State Contract) between the Department of Health and Human Services (the Department) and the selected Medicaid Managed Care plans (i.e., Prepaid Health Plans or PHPs) indicates that contracts between PHPs and providers shall comply with the terms of the State Contract and must be approved by the Department.
Provision of eye examination and visual aids for beneficiaries under 21 years of age as well as beneficiaries over 21 years of age.
List of applicable co-payments for adult Medicaid beneficiaries (21 years of age and older)
On May 15, 2019, an amended version of Clinical Coverage Policy 10C, Outpatient Specialized Therapies, Local Education Agencies (LEAs), was posted to the North Carolina Medicaid website. The following updates were made in accordance with State Plan Amendment (SPA) NC 18-0005.
The Secretary of the N.C. Department of Health and Human Services (DHHS) has approved the disengagement of Rutherford County from the VAYA Health Local Management Entity-Managed Care Organization (LME-MCO) and their alignment with Partners Behavioral Health Management LME-MCO.
Effective with date of service 3/8/2019, the North Carolina Medicaid and NC Health Choice programs cover esketamine nasal spray (Spravato™) for use in the Physician Administered Drug Program when billed with HCPCS code J3490 - Unclassified drugs.