FDA has expanded the use of single booster dose to include ages 12-15.
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Since the launch of NC Medicaid Managed Care on July 1, 2021, providers have submitted claims to the prepaid health plans (PHPs) for services provided to beneficiaries who are enrolled with that PHP.
Reinstatement of temporary suspension of prior authorization for inpatient rehabilitation hospital and long-term care hospital admissions under NC Medicaid Managed Care.
Emergency use of Evusheld approved by FDA
Providers should bill with Revenue Code 0771 instead of Revenue Code 0261 on future claims for the vaccine and monoclonal antibody administration services.
Fact sheets that address questions related to the Standard Plan disenrollment process for children in foster care are now available.
On Dec. 20, 2021, the Department announced that the Healthy Opportunities Pilot will shift the start of Pilot service delivery from Feb. 1, 2022 to March 15, 2022. The Department will now take a phased approach to launching Healthy Opportunities Pilot services in all three Pilot regions.
Reimbursement for COVID-19 Specimen Collection
DME/POS providers may issue medically necessary equipment & supplies
Effective with date of service Nov 1, 2021, Medicaid and NC Health Choice programs cover pneumococcal 15-valent conjugate vaccine suspension for intramuscular injection (Vaxneuvance™).
Effective with date of service Oct. 22, 2021, Medicaid and NC Health Choice programs cover afamelanotide implant, for subcutaneous use (Scenesse®).
Key dates, Playbook updates, Medicaid Direct, fabrication of eyeglasses, managed care eligibility for newborns, prior authorization, FAQs, Provider Ombudsman, Provider directory, PHP quick reference guides and help center.
Summary network adequacy results for Standard Plans are available.
This group includes MAFDN Family Planning Medicaid and uninsured MCV beneficiaries.