Blog Entry List

Members may now select to receive Tailored Care Management from a provider with Transition to Community Living Distinction.
Feedback Requested on Proposed Approach
To support the SNF and ICF-IID reporting and collection of provider healthcare assessment data.
Expanding Pilot Eligibility to Members in NC Medicaid Direct in Pilot Regions
Billing Requirements for Medicaid Direct Providers
Forum to be held Tuesday, June 25 in Concord.
Look for details on training in June related to these changes.
States must revalidate the enrollment of all providers at least every five years to ensure the information on record is accurate and current.
Withdrawal Management Policies Delayed
The audit will sample fee-for-service claims collected for a full year – July 1, 2024, through June 30, 2025.
Recent State Plan Amendment outlines duties of a responsible third party
New separately reimbursable CPT codes in the ambulatory surgery setting
Updates on the Sandata mobile app, telephony and fixed visit verification.
Providers should work with their Medicaid beneficiary’s health plan and Tailored Care Manager to transition the members to 1915(i) services.
Revised policy in addition to services outlined in Maternity Coverage and Reimbursement Bulletin posted Oct. 23, 2023.