Blog Entry List
Highlighting coverage, rate and resource changes in 2022
Last days for providers to have fully executed contracts with Tailored Plans to be included in the beneficiary choice period and auto-assignment.
Changes requirement to “comprehensive annual exam or annual assessment” prior to providing family planning and related services.
Documents modifying the Skilled Nursing Facilities Provider Assessment and temporary COVID-19 add-on, and SNF per diem rates are impacted.
Effective with date of service Oct. 19, 2022, Medicaid and NC Health Choice cover Sodium Thiosulfate injection, for intravenous use (Pedmark).
Effective with date of service Nov. 15, 2022, Medicaid and NC Health Choice cover Eflapegrastim-xnst injection, for subcutaneous use (Rolvedon).
When the service location field is not completed, the Alt EVV vendor will receive an exception notice.
This bulletin replaces the previous bulletin published Nov. 21, 2022.
Replaces the prior version issued in February 2022
A multidisciplinary care team will provide whole-person care management that addresses all of a beneficiary’s needs
Upcoming milestones, Provider Playbook updates, organizational Provider affiliation requirement, Beneficiary assignment file and more
This bulletin provides guidance to assist hospital providers’ compliance with federal requirements.
Vaccine Immunization Claims Can Be Submitted on Pharmacy Claims for NC Medicaid Direct Beneficiaries
Effective Dec. 1, 2022, pharmacy providers who administer immunizations at pharmacies may bill NC Medicaid Direct for vaccines on pharmacy claims
Effective with date of service Oct. 3, 2022, Medicaid and NC Health Choice cover Ranibizumab-eqrn injection, (Cimerli)