Blog Entry List

Effective May 1, 2019, beneficiaries requesting Personal Care Services must use the updated NC Medicaid-3051 Request for Independent Assessment for Personal Care Services Attestation of Medical Need Form. This form is a revision of the currently used NC Medicaid-3051 Form. The current form will be accepted by the Independent Assessment Entity through July 1, 2019.

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.

Session Law 2017-57, Section 11H.13/(a) was amended to appropriate funding to be used to increase the rate for in-home aide services to no more than three dollars and ninety cents ($3.90) paid per 15-minute billing unit provided under the Community Alternatives Program for Disabled Adults (CAP/DA) waiver pursuant to Clinical Coverage Policy 3K-2, effective Jan. 1, 2019.

A renewal application for § 1915 (c) Home and Community-Based Services (HCBS) waiver for the Community Alternatives Program for Disabled Adults (CAP/DA) was submitted to the Centers for Medicare & Medicaid Services (CMS) on Mar. 1, 2019 for review and approval.

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.

NC Medicaid has approved the release of a Request for Proposal (RFP) for an independent assessment entity (IAE) that will streamline access to Medicaid Long-Term Services and Supports (LTSS) effective July 2019. The IAE will provide beneficiaries a much-needed single point of entry for accessing Medicaid LTSS services and streamline the processes between initial contact and service enrollment.

Effective with date of service Dec. 17, 2018, the North Carolina Medicaid and NC Health Choice programs cover levoleucovorin for injection, for intravenous use (Khapzory) for use in the Physician Administered Drug Program when billed with HCPCS code J3490 - Unclassified drugs.

Effective with date of service Dec. 21, 2018, the North Carolina Medicaid and NC Health Choice programs cover ravulizumab-cwvz injection, for intravenous use (Ultomiris) for use in the Physician Administered Drug Program when billed with HCPCS code J3590 - Unclassified Biologics.

Effective Jan. 31, 2019, NC Medicaid’s Community Alternatives Program for Children (CAP/C) approves specialized medical equipment and supplies for an adaptive car seat and a vehicular transport vest for participants in CAP/C when all qualifying conditions are met per the CAP/C Clinical Coverage Policy, 3K-1.