Topics Related to Bulletins
Effective July 1, 2018, North Carolina Medicaid and NC Health Choice behavioral health providers who were added to NCTracks via the Local Management Entity/Managed Care Organization Provider Upload process must complete reverification. Providers identified are being notified of their reverification due date via NCTracks communication to the Office Administrator on record.
Beginning Sept.1, 2018, adult care home and nursing home Pre-Admission Screening and Resident Review submissions through Provider Link will no longer be accepted. PASRR submissions will only be accepted via NC Medicaid Uniform Screening Tool.
Providers must submit a Fingerprinting Criminal Background Check application within 30 days of receiving the request notification to avoid being terminated for cause.
Note: This article was originally published as a Special Bulletin in January 2018, with updates regarding clinical pharmacist practitioners.
The following new or amended combined North Carolina Medicaid and NC Health Choice clinical coverage policies are available on Medicaid’s Clinical Coverage Policy web pages.
Centers for Medicare & Medicaid Services (CMS) is overhauling and streamlining the Electronic Health Record (EHR) Incentive Program. The goal is to move the program beyond requirements for meaningful use (MU) to increase focus on interoperability and improving patient access to health information.
Effective Oct. 1, 2017, Clinical Coverage Policy 2B-1, Nursing Facility Services, was revised in accordance with 42 CFR 483 Subpart B.
Clinical Coverage Policy 11A-15, Hematopoietic Stem-Cell Transplantation for Solid Tumors of Childhood, has been revised.
Effective July 1, 2018, North Carolina Medicaid has revised Clinical Coverage Policy (CCP) 1-O-3, Keloid Excision and Scar Revision, to clarify the procedure for proper submission of preoperative photographs to CSRA as part of the prior approval process. The preoperative photographs of keloids or scars should be clearly marked with:
Effective Jan. 1, 2018, North Carolina Medicaid increased the rates for mammography procedure codes 77065, 77066, and 77067. Medicaid has identified the claims that have been affected by this change.
A systematic reprocessing for professional, Medicare Part B Crossover Professional, Rural Health Clinic (RHC), Local Health Department (LHD) and Federally Qualified Health Center (FQHC) claims with dates of service Jan. 1, 2018 through Feb. 23, 2018 – that were paid in NCTracks from Jan. 1, 2018 through March 6, 2018 – will be reprocessed in the June 12, 2018, checkwrite.
A systematic reprocessing for professional, Medicare Part B Crossover Professional, Rural Health Clinic (RHC), Local Health Department (LHD) and Federally Qualified Health Center (FQHC) claims with dates of service Jan. 1, 2018 through Feb. 23, 2018 – that were paid in NCTracks from Jan. 1, 2018 through March 6, 2018 – will be reprocessed in the June 12, 2018, checkwrite.