NC Medicaid reimburses for the provision of the vaccine at the same rate as Medicare and is creating an additional payment to encourage access to vaccines during the Public Health Emergency.
Blog Entry List
The webinar series runs from October through mid-December.
Effective June 8, 2021, Medicaid will pay an extra $35, in addition to the standard administration payment (approximately $40 per COVID-19 vaccine dose), for a total payment of approximately $75 for a vaccine dose administered in a patient's home.
Effective Sept. 1, 2021, the Acute Hospital Care at Home (HAH) program will be available to North Carolina hospitals that have been granted a waiver from CMS and service NC Medicaid beneficiaries. NC Medicaid is planning to implement this program to be effective Sept. 1 through Dec. 31, 2021, unless this flexibility is terminated prior to Dec. 31, 2021.
The NCTracks provider record serves as the source of truth for managed care entities.
Due to the rapid increase in COVID infection and related hospitalization occupancy, NC Medicaid is reactivating its consideration of Response Facility Designation Requests submitted by skilled nursing facilities.
NC Medicaid Managed Care launched on July 1, 2021. Within the first 90 days of launch, beneficiaries can change their prepaid health plan (PHP) for any reason. The 90-day choice period ends on Sept. 30, 2021 for beneficiaries that moved to Managed Care on July 1, 2021.
Prepaid health plans are required to pay interest and penalties to providers if they fail to accurately pay or inappropriately deny a claim.
NC Medicaid is extending all current COVID-19 temporary provider rate increases through Nov. 30, 2021. While the rate increases for providers authorized under SL 2020-4 were set to expire on June 30, 2021, NC Medicaid has discretion to continue these and other temporary rate increases assuming budget availability.
Topics include key dates, playbook updates, prior authorization, FAQs, contracting, ombudsman, webinars and more.
Effective Oct. 15, 2021, CDSAs and independent practitioners providing individualized family service plan services must resume submitting PA requests.
Effective Aug. 18, 2021, the Medicaid and NC Health Choice programs cover anifrolumab-fnia injection
Two Months Left to Submit Program Year 2021 Attestations; Security Risk Analysis
Will cover all U.S. FDA approved CAR T-Cell Therapies when administered per U.S. FDA approved guidelines