Topics Related to Bulletins

Effective with the date of service of April 30, 2018, the North Carolina Medicaid and Health Choice programs will be terminating Clinical Policy 1B-3, Intravenous Iron Therapy, within the Physician Drug Program.

Effective with the date of service of April 30, 2018, the North Carolina Medicaid and N.C. Health Choice programs will be terminating Clinical Policy 1B-3, Intravenous Iron Therapy, within the Physician Drug Program.

Effective with the date of service of April 30, 2018, the North Carolina Medicaid and N.C. Health Choice programs will be terminating Clinical Policy 1B-3, Intravenous Iron Therapy, within the Physician Drug Program.

The following updates are in effect for the Orthotics & Prosthetics (O&P) policy to comply with the Centers for Medicare and Medicaid Services (CMS) Attending, Rendering, Ordering, Prescribing or Referring Providers Federal Regulation, 42 CFR, Part 455.410, and to clarify compliance with the CMS Home Health Final Rule, 42 CFR, Part 440.70.

On Jan. 28, 2018, the NC Department of Health and Human Services (DHHS) implemented updates to NCTracks pharmacy prior approval (PA) requests for North Carolina Medicaid and NC Health Choice beneficiaries.

The Verification of School Nursing Form – Attachment I (DMA-3171), and Instruction Sheet (DMA-3171-I) are now on the NC Medicaid PDN forms web page.

By Feb. 28, 2018, non-accredited nursing service providers previously providing services under the Community Alternatives Program for Children (CAP-C) waiver must obtain accreditation and meet all required occupational licensing entity regulations.

With each prior approval (PA) entry beginning with the third and subsequent benefit periods, providers must fax a copy of the Approval Status Inquiry Form, or the NCTracks Web Submitted Request for Hospice Prior Approval Confirmation Page, to DMA at 919-715-9025. DMA requests that providers include their name and e-mail address on the above forms.

The Freestanding Birth Center fee for CPT Code 59409 has been updated to $1,510.97 effective Jan. 1, 2018.

Registration is open for several instructor-led training courses for providers that will be held in January 2018.