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Blog Entry List
The Payment Error Rate Measurement (PERM) is an audit program developed and implemented by the Centers for Medicare & Medicaid Services (CMS) as required by the Improper Payments Information Act (IPIA) of 2002. It is used nationwide to review beneficiary eligibility determinations and claims payments made by North Carolina Medicaid and NC Health Choice to ensure that states only pay for appropriate claims. A national report is distributed outlining the various error rates among states.
New or amended clinical coverage policies are available on NC Medicaid’s website.
April is the last month to submit an attestation for Program Year 2018. The NC Medicaid EHR Incentive Payment System (NC-MIPS) will close for Program Year 2018 at midnight on Apr. 30, 2019. After that no changes can be made. Eligible professionals (EP) are strongly advised to review their attestation and documentation for accuracy and completeness
Beginning in April, participating health care providers in the state-designated health information exchange (HIE), NC HealthConnex, will be moving to a new HIE platform.
The State and GDIT are in the process of completing NCTracks system updates to provide notification on the Remittance Statement of adjustment actions taken on previously paid claims due to audits conducted by Third Party Recovery and the Office of Compliance and Program Integrity.
Registration is open for the April 2019 instructor-led provider training courses listed below. Slots are limited.
WebEx courses can be attended remotely from any location with a telephone, computer and internet connection. Please note that the WebEx information has changed.
NC Medicaid has developed a general overview and topic-based webinar series that will educate providers to effectively support their transition to Medicaid Managed Care. General webinars are designed to give providers an overview of major changes and important things to know while the focused, topical webinar series will offer a deeper dive on specific topics.
On Feb. 4, 2019, the North Carolina Department of Health and Human Services announced the selection of five Prepaid Health Plans that will participate in Medicaid managed care when the program launches in November 2019.
NCTracks receives files from the North Carolina Medical Board the first week of every month. Providers do not need to update their license renewals in NCTracks. The expiration date will be updated by NCTracks automatically as long as the license number on the provider's record is correct and matches the license number issued by the Board.
The following new or amended clinical coverage policies are available on NC Medicaid’s website:
There are only two months left to submit an attestation for Program Year 2018. The NC Medicaid EHR Incentive Payment System (NC-MIPS) will close for Program Year 2018 at midnight on April 30, 2019. After that, no changes can be made.
Registration is open for the March 2019 instructor-led provider training courses listed below. Slots are limited. WebEx courses can be attended remotely from any location with a telephone, computer and internet connection.
Proposed new or amended North Carolina Medicaid and NC Health Choice clinical coverage policies are posted for comment throughout the month.
This is a reminder that not all drugs administered by injection or infusion are covered in the Physicians Drug Program (PDP) as a part of the medical benefit. Some of these drugs are only covered in the outpatient pharmacy benefit when requested by prior authorization (PA) and dispensed by a retail or specialty pharmacy.