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. 

End-Dating the Use of Taxonomy Code 313M00000X (Nursing Home-Intermediate Level of Care) From Provider Permissions Matrix, Continuation of Temporary Suspension of Level I and Level II Assessments for New Nursing Home Admissions, NCMUST Webpage Update, PASRR Submission and Required Supporting Documentation

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.  

An amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies with an effective date of April 1, 2021, was posted to the NC Medicaid Clinical Coverage Policy web page.

An amended version of Clinical Coverage Policy 5A-2, Respiratory Equipment and Supplies with an effective date of April 1, 2021, was posted to the NC Medicaid Clinical Coverage Policy web page. 

NC Medicaid implemented system changes on May 9, 2021, requiring providers to keep credentials current on their NCTracks provider enrollment record.