Clinical Coverage Policy 1N-2, Allergy Immunotherapy has been revised effective Jan. 1, 2019, to reflect changes in unit dosing.
Topics Related to Bulletins
Registration is open for the January 2019 instructor-led provider training courses listed below. Slots are limited. WebEx courses can be attended remotely from any location with a telephone, computer and internet connection. Please note that the WebEx information has changed.
There are only four months left to submit an attestation for Program Year 2018. Attestations submitted after Feb. 28, 2019 are not guaranteed to be reviewed by program staff prior to close of Program Year 2018. Providers have until April 30, 2019 to submit a complete and accurate attestation for Program Year 2018. After that no changes can be made.
As a reminder, providers are to request and obtain proper prior authorization before services are scheduled or rendered. Contractually, GDIT has five business days (excluding holidays and weekends) to process a medical PA request once all required information is obtained. Pharmacy PAs are processed within 24 hours. Medical necessity cannot be determined with a partial or incomplete clinical picture.
The following new or amended clinical coverage policies are available on NC Medicaid’s clinical coverage policies web page:
NC Medicaid has been reviewing the Medicaid Durable Medical Equipment rates to comply with the new Centers for Medicare and Medicaid Upper Payment Limit requirements. While further review is needed, NC Medicaid wanted to publish this bulletin to provide a status update.
Effective Jan. 1, 2019, optical services shall be covered for adult Medicaid beneficiaries in accordance with S. L. 2018-97, Part III, Section 11H.13.(c). However, Centers for Medicare and Medicaid Services (CMS) approval of the corresponding State Plan Amendment is pending.
This article talks about the new help desk number for PASRR, the new fax number for PASRR-related documents and uploading PASRR-related documents to NCMUST.
In accordance with the North Carolina Medicaid State Plan, Federally Qualified Health Centers and Rural Health Centers may request a rate adjustment due to change in scope of services.
Out-of-state providers, including border-area providers, must be enrolled in Medicare or their home-state Medicaid program to enroll in North Carolina Medicaid and NC Health Choice programs.