Topics Related to Bulletins
Per the Sept. 12, 2018, South Carolina Department of Health and Human Services (SCDHHS) Medicaid Bulletin, SCDHHS will, in good faith, reimburse North Carolina qualified providers not currently enrolled with or otherwise pre-approved by the South Carolina Medicaid program for medically necessary and time-sensitive services rendered to South Carolina Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries.
Beginning Sept.1, 2018, adult care home and nursing home Pre-Admission Screening and Resident Review (PASRR) submissions through Provider Link will no longer be accepted.
A list of providers scheduled for re-credentialing in 2018 is available on the Provider Enrollment Page of the North Carolina Medicaid website under the "Re-credentialing" header.
Fingerprinting is only required for high-risk providers as identified by 42 CFR 424.518(c), NC General Statute 108C-3g and Session Law 2018-5 SB99.
Federal regulation 42 CFR 455.450 requires a state Medicaid agency to screen all initial provider applications based on a categorical risk level.
Medicaid has been made aware of reimbursement delays when claims for medical services are billed for inpatient services with a psychiatric diagnosis as the primary diagnosis.
If a provider’s enrollment application or Manage Change Request (MCR) does not contain errors, it will process more quickly. The NCTracks Enrollment Team identified commons errors that cause delays in processing applications and MCRs.
Registration is open for the August 2018 instructor-led provider training courses listed below. Slots are limited.
The following new or amended combined North Carolina Medicaid and NC Health Choice clinical coverage policies are available on Medicaid’s website:
As previously communicated in the July 2018 North Carolina Medicaid Special Bulletin, the NPI Exemption List will cease Aug. 31, 2018, for Clinical Pharmacist Practitioners (CPPs), Residents and Interns.