Topics Related to Bulletins

On June 1, 2018, hospitals, physicians, physician assistants and nurse practitioners with an electronic health record system must have initiated a connection to NC HealthConnex, North Carolina’s designated statewide health information exchange network.
This announcement is to inform Community Alternatives Program for Children providers of revisions to the technical changes in Clinical Coverage Policy, 3K-1, Community Alternatives Program for Children (CAP/C). 
In response to provider comments and questions regarding billing under the new federal Ordering, Prescribing and Referring (OPR) rules, North Carolina Medicaid is issuing this clarification for radiology and Independent Diagnostic Testing Facilities (IDTF).
In response to the higher than normal number of influenza cases and influenza-related complications and deaths, North Carolina Medicaid is offering telephonic evaluation and management services to beneficiaries who are actively experiencing flu-like symptoms. The purpose of this service is to assist primary care providers assessing established patients over the telephone to gather additional information.
The use of the NPI Exemption List for residents and interns enrolled in graduate dental and medical programs, and area health education centers will cease on Jan. 31, 2018. Clinical Pharmacist Practitioners will continue to use the NPI Exemption List until further notice.
In response to provider feedback, the use of the NPI Exemption List for residents and interns enrolled in graduate dental and medical programs, and area health education centers will be extended from January 31, 2018 to April 30, 2018. 

Clinical pharmacist practitioners will continue to use the NPI Exemption List until further notice.   
The Department of Health and Human Services, Division of Medical Assistance, provides notice of its intent to amend the Medicaid State Plan to increase the rates for metabolic formula – Durable Medical Equipment.
By July 1, 2018, Medicaid behavioral health providers added to NCTracks by their current Local Management Entity/Managed Care Organization Provider Upload Process must complete re-verification.
Per Session Law (S.L.) 2015-241, as of June 1, 2018, hospitals, mid-level physicians and nurse practitioners who currently have an electronic health record system must be connected to NC HealthConnex to continue to receive payments for Medicaid and NCHC services.
The implementation of ICD-10-CM allows specificity for accurate coding, resulting in greater justification of medical necessity. A provider’s documentation must include details to completely depict the nature of a beneficiary’s diagnosis and procedures performed.