Blog Entry List
Revisions have been made to Clinical Policy 1A-20, Sleep Studies and Polysomnography Services effective May 1, 2021.
NC Medicaid will sunset its CARES Act funded reimbursement of nursing facility staff COVID-19 testing in June 2021. This bulletin provides an update on processing timelines for previously submitted cases and provides additional guidance for final payments under this initiative.
Topics include: key dates, contracting reminders, provider ombudsman, playbook updates, outreach to patient panels, webinars, provider directory, PHP quick reference guides, Help Center and Tailored Care Management certification.
DHHS will hold a webinar on June 4, 2021, to provide an update on the development of the Specialized Foster Care Plan.
NC DHHS announced the selection of organizations to serve three regions of the state
Medicaid beneficiaries currently eligible to transition to managed care have selected or been assigned a health plan.
To ensure providers meet contractual obligations to keep credentials current, notifications of suspension for failure to update a credential prior to the expiration date on file with NCTracks were implemented in May.
Due to confusion with the language in Clinical Coverage Policy 1A-22, Medically Necessary Circumcision, the policy has been revised with grammar and punctuation updates.
NC Medicaid is updating the 1G-2 Skin Substitutes Policy.
NCDHHS is releasing data on the number of beneficiaries, as of April 2021, who currently meet the eligibility criteria to enroll in Tailored Plans and receive Tailored Care Management scheduled to launch in July 2022.
Affected providers should resubmit claims that were denied for procedure code 58661 at this time.
NC Medicaid implemented system changes on May 9, 2021, requiring providers to keep credentials current on their NCTracks provider enrollment record.
NC Medicaid has published updated guidance on Tailored Care Management, including updates on Advanced Medical Home + (AMH+)/Care Management Agency (CMA) Certification, capacity building and rates.
NCDHHS is in its final week of open enrollment for NC Medicaid Managed Care. Through Friday, May 14, beneficiaries can choose a primary care provider (PCP) and a health plan for their families’ care in preparation for the launch of NC Medicaid Managed Care on July 1.
On May 9, 2021, NC Medicaid is taking additional steps to ensure providers meet their contractual obligation to keep credentials current on their NCTracks enrollment. NCTracks will generate a notification to providers at 60, 30 and 14 calendar days prior to the expiration date of the credential; and will begin a process of suspension if a provider fails to update their credential.