Effective with date of service May 1, 2018, the North Carolina Medicaid and N.C. Health Choice programs covers fosnetupitant and palonosetron for injection, for intravenous use (Akynzeo) for use in the Physician’s Drug Program when billed with HCPCS code J3490 - Unclassified drugs.
Blog Entry List
Registration is open for the July 2018 instructor-led provider training courses listed below. Slots are limited.
Centers for Medicare & Medicaid Services is streamlining the Electronic Health Record Incentive Program. The goal is to move the program beyond requirements for meaningful use to increase focus on interoperability and improving patient access to health information.
Note: This article was originally published in the June 2018 Medicaid Bulletin with a clarification that only high-risk providers must obtain fingerprints.
Effective Aug. 1, 2018, North Carolina Medicaid will make a change to the North Carolina Medicaid and N.C. Health Choice Preferred Drug List (PDL) in the Antihyperkinesis/Attention Deficit Hyperactivity Disorder (ADHD) class.
These guidelines assist with claim submissions for dually eligible beneficiaries. This information addresses situations known to affect a significant number of claims. It is not feasible to provide an all-inclusive list due to the variable nature of the programs.
Medicaid’s Third-Party Liability contractor, Health Management Systems, Inc., will implement a Commercial Insurance Disallowance project to streamline North Carolina’s coordination of benefits and direct billing processes. The expected date for implementation is Oct. 1, 2018.
On June 1, 2018, hospitals, physicians, physician assistants and nurse practitioners with an electronic health record system must have initiated a connection to NC HealthConnex, North Carolina’s designated statewide health information exchange network.
Effective Jan. 1, 2018, North Carolina Medicaid increased the rates for mammography procedure codes 77065, 77066, and 77067. Medicaid has identified the claims that have been affected by this change.
Effective July 1, 2018, North Carolina Medicaid has revised Clinical Coverage Policy (CCP) 1-O-3, Keloid Excision and Scar Revision, to clarify the procedure for proper submission of preoperative photographs to CSRA as part of the prior approval process.
Clinical Coverage Policy 11A-15, Hematopoietic Stem-Cell Transplantation for Solid Tumors of Childhood, has been revised.
Effective Oct. 1, 2017, Clinical Coverage Policy 2B-1, Nursing Facility Services, was revised in accordance with 42 CFR 483 Subpart B.
Centers for Medicare & Medicaid Services (CMS) is overhauling and streamlining the Electronic Health Record (EHR) Incentive Program. The goal is to move the program beyond requirements for meaningful use (MU) to increase focus on interoperability and improving patient access to health information.
The following new or amended combined North Carolina Medicaid and NC Health Choice clinical coverage policies are available on Medicaid’s Clinical Coverage Policy web pages.
Registration is open for the June 2018 instructor-led provider training courses listed below. Slots are limited.