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.
Topics Related to Bulletins
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.
NC-MIPS is accepting Program Year 2018 Modified Stage 2 and Stage 3 MU attestations.
Effective with date of service May 1, 2018, the North Carolina Medicaid and N.C. Health Choice programs covers fosnetupitant and palonosetron for injection, for intravenous use (Akynzeo) for use in the Physician’s Drug Program when billed with HCPCS code J3490 - Unclassified drugs.