Beginning Oct. 15, 2019, North Carolina Medicaid Bulletin articles will be delivered more often and in an online format. The improvements are in response to feedback from providers looking for a flexible way to receive important Medicaid information to better serve beneficiaries and more effectively operate their businesses.
Blog Entry List
*NOTE: THE CONTENT OF THIS BULLETIN IS AN UPDATE TO A MEDICAID SPECIAL BULLETIN PREVIOUSLY PUBLISHED ON SEPT. 5, 2019 REGARDING FLEXIBILITIES RELATED TO HURRICANE DORIAN.
This Special Bulletin includes several articles regarding Hurricane Dorian.
For inclusion in auto-enrollment, provider contracts must be signed and mailed to health plans no later than Nov. 15, 2019.
For inclusion in auto-enrollment, provider contracts must be signed and mailed to the health plans no later than Nov. 15, 2019. A list of questions and answers is provided for reference regarding this deadline.
NC Medicaid will reprocess claims with dates of service between Jan. 1, 2019 and Sept. 3, 2019, paid to primary care physicians, nurse practitioners and physician assistants submitted with E&M codes ranging from 99201 to 99499 and the corresponding taxonomies as defined in Section 1202 of the Affordable Care Act (ACA).
*NOTE: THE CONTENT OF THIS BULLETIN HAS BEEN UPDATED. REFER TO THE SEPT. 24, 2019 MEDICAID SPECIAL BULLETIN FOR REVISED FLEXIBILITIES.
This Special Bulletin includes several articles regarding Hurricane Dorian.
As of the end of August 2019, several issues have been identified with the search function in the Enrollment Broker Provider Directory, including duplicate results, and difficulty finding doctors based on specific criteria such as gender or name.
The Department of Health and Human Services (DHHS) recently launched an online “Provider Playbook” as part of its commitment to ensure providers have resources to help Medicaid beneficiaries transition smoothly to Medicaid Managed Care. This new Provider Playbook is a collection of information and tools specifically tailored to providers.
Supporting beneficiaries in their transition between the current fee-for-service delivery system and NC Medicaid Managed Care is called transition of care. The transitional period surrounding the launch of Medicaid Managed Care is referenced as crossover.
The North Carolina Division of Health Benefits (DHB) would like to reiterate the 340B provider and claim submission requirements for both the outpatient pharmacy and Physician’s Drug Program (PDP).
The NC Medicaid EHR Incentive Payment System (NC-MIPS) is only accepting Program Year 2019 Stage 3 Meaningful Use (MU) attestations. All eligible professionals (EPs) attesting in Program Year 2019 will be required to attest to Stage 3 MU and use a 2015 Edition of certified EHR technology (CEHRT).
North Carolina’s state-designated health information exchange, NC HealthConnex, was created in 2015 by the North Carolina General Assembly to help bridge the gap between distinct electronic health record systems and health care networks to support whole patient care. With over seven million unique patient records and growing, NC HealthConnex is working to connect the state’s health care providers to deliver a holistic view of a patient’s record.
A fully detailed outline of the influenza vaccine and reimbursement guidelines for 2019-2020 for North Carolina Medicaid and NC Health Choice was distributed in a Medicaid Special Bulletin on Aug. 27, 2019.
Session Law 2018-5 Sec.11H.4 (see Appendix A) instructed the NC Department of Health and Human Services (DHHS) to submit to Centers for Medicare and Medicaid Services (CMS) for the necessary authority to establish Medicaid reimbursement for ambulance transports of Medicaid beneficiaries in behavioral health crisis to behavioral health clinics or other alternative locations effective July 1, 2019.
Several new or amended clinical coverage policies are available on NC Medicaid’s website.