Blog Entry List

NC Medicaid EHR Incentive Program Announcements - September, 2021

Two Months Left to Submit Program Year 2021 Attestations; Security Risk Analysis

North Carolina Standard & Tailored Plan Tobacco-Free Policy Requirement

Tobacco-related policy requirements go into effect on July 1, 2022.

SPECIAL BULLETIN COVID-19 #178: Temporary Provisions for COVID Surge: Post-Acute PA Exceptions and Hospital at Home Program

Temporary Suspension of Prior Authorization for Post-Acute Placements and Temporary Availability of the Hospital at Home Program

Influenza Vaccine and Reimbursement Guidelines for 2021-2022 for NC Medicaid and NC Health Choice

Billing codes for Medicaid beneficiaries

Medicaid Claims Documentation: 2020 Single State Audit

Tips for providers to reduce the likelihood of future documentation errors

Single State Audit SFY2021

OSA has begun the Single Audit for state fiscal year 2021

Claims Denied – Taxonomy Codes Missing, Incorrect, or Inactive

Taxonomy codes must be included when submitting claims to prepaid health plans

Rebate Eligible Prescription Drug Coverage by Prepaid Health Plans

PHPs are required to provide drug coverage to Medicaid beneficiaries consistent with the drug coverage determined by NC Medicaid under fee for service.

In-Network Provisions Extended Through September

To support providers during the recent COVID-19 surge, the policy for in-network provider provisions has been extended

Tailored Care Management: Conflict-Free Care Management Guidance

Ensure compliance with the HCBS final rule and prepare Tailored Plans and Providers for the launch of Tailored Care Management.

Extension of Out-of-Network Provisions

The policy is extended through Nov. 30, 2021.

Expedited Hardship Advances for Managed Care Providers

May be available for those at risk of not meeting financial obligations

Billing Guidance for Children’s Developmental Services Agency Providers

Claims may be submitted to NCTracks for all IFSP services for dates of service starting on July 1, 2021.

Procedures for Prior Authorization of Palivizumab (Synagis®) for Respiratory Syncytial Virus Season 2021-2022

Coverage season will begin Aug. 15, 2021

Prior Authorization for Physician Administered Drug Program

Not required for medications administered at the provider’s office or outpatient hospital clinic settings and billed as part of the professional claim (Physician Administered Drug Program).