Blog Entry List
Ventolin® HFA will shift from Non-Preferred to Preferred on the Preferred Drug List (PDL), effective Sept. 23, 2022.
Coverage season starts Oct. 1, 2022.
The 2023 ICD-10 update is effective Oct. 1, 2022, through Sept. 30, 2023, for provider use for dates of service within this period.
Key milestones, playbook updates, verifying eligibility, provider reverification, provider records, behavioral health services transition and more
Providers should contact the PHPs and Provider Ombudsman to resolve issues.
Updates to Clinical Coverage Policy 1A-5 with an effective date of Sept. 2, 2022.
Attention Standard Plans/Tailored Plans/HHA Exchange/CareBridge and Healthy Blue
Updates on Tailored Plan criteria review, eligibility criteria, enrollment and health care options, and resources for Beneficiaries and Providers.
What services are available, in which regions, and how providers can refer patients.
Providers shall not bill a NC Medicaid beneficiary for services furnished to a beneficiary who the provider has accepted as a Medicaid patient.
The adjudication of some prior approvals will be performed by GDIT Fiscal Agent Operations Reviewers instead of clinical reviewers at NC Medicaid
NC Medicaid is working with Standard Plans to create easier pathways for providers to reach Standard Plans and resolve panel issues.
Effective July 1, 2022, Medicaid and NC Health Choice cover kit for the preparation of Gallium Ga 68 gozetotide injection
NCDHHS will implement an Electronic Visit Verification system for Home Health Care services starting with a soft launch Jan. 1, 2023, and a hard launch April 1, 2023. This complies with the 21st Century Cures Act.
Service field location effective date change from Oct. 5, 2022, to Jan. 1, 2023