Blog Entry List
The North Carolina Department of Health and Human Services (DHHS) has expanded the regions awarded to Carolina Complete Health, Inc. (CCH) to serve as a health plan under the state’s transition to Medicaid Managed Care. In addition to serving regions 3 and 5 in the state, the provider-led health plan will also serve region 4.
The clinical criteria used by NC Medicaid for the 2019-2020 Respiratory Syncytial Virus (RSV) season are consistent with guidance published by the American Academy of Pediatrics (AAP): 2018 – 2021 Report of the Committee on Infectious Diseases, 31st Edition. This guidance for Synagis use among infants and children at increased risk of hospitalization for RSV infection is available online by subscription. The coverage season is Nov. 1, 2019, through March 31, 2020. Providers are encouraged to review the AAP guidance prior to the start of the RSV season.
Several new or amended clinical coverage policies are available on NC Medicaid’s website.
Providers were notified in the August Medicaid bulletin that as of May 1, 2019, the sterilization consent form was updated with an expiration date of April 30, 2022. The sterilization consent form found on the U.S. Department of Health & Human Services (HHS) website has been updated. Providers should now be using this version when submitting the sterilization consent form to the NC Medicaid fiscal agent.
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).
The 2020 ICD-10 update will be in place effective Oct. 1, 2019 through Sept. 30, 2020, for provider use. Providers can access the list of ICD-10 codes on the Centers for Medicare and Medicaid Services (CMS) website.
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.
*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. DHHS is working diligently to resolve the issues.
Currently, search results are inconsistent and have led to many questions. For example:
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.