Blog Entry List
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.
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.
Prepaid health plans are required to pay interest and penalties to providers if they fail to accurately pay or inappropriately deny a claim.
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
Providers are encouraged to confirm which PA types are included in this long-term design.
Will cover all U.S. FDA approved CAR T-Cell Therapies when administered per U.S. FDA approved guidelines
Two Months Left to Submit Program Year 2021 Attestations; Security Risk Analysis
Tobacco-related policy requirements go into effect on July 1, 2022.
Temporary Suspension of Prior Authorization for Post-Acute Placements and Temporary Availability of the Hospital at Home Program